title: The effect of systemic antibiotics administered during the active phase of non-surgical periodontal therapy or after the healing phase: a systematic review.
abstract: OBJECTIVE
  The aim of this systematic review was to compare the clinical effectiveness of systemic antibiotics administered in the active stage of periodontal treatment or after the healing phase.
  
  
  METHODS
  An electronic search was performed in the databases EMBASE, MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL), in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. A manual search of the reference list of selected studies and of review articles was also performed up to November 2013. Randomized Clinical Trials (RCT) that evaluated the systemic administration of antibiotics as adjuvants to scaling and root planning (SRP) at different phases of periodontal treatment were included. Systematic reviews and studies that evaluated subjects with systemic diseases and those that used subantimicrobial doses of antibiotics were excluded.
  
  
  RESULTS
  The initial search identified 1,039 articles, of which seven were selected, and only one met the inclusion criteria. This study showed that subjects taking metronidazole and amoxicillin at the initial phase of treatment exhibited statistically significantly greater reduction in pocket depth and gain in clinical attachment level in initially deep sites (PD≥7 mm) than subjects taking antibiotics after healing (p<0.05). This comparison was conducted 2 months after antibiotic intake, at the healing phase.
  
  
  CONCLUSIONS
  To date, only one short-term RCT has directly compared different moments of systemic antibiotics administration, as adjuncts to SRP, in the treatment of periodontitis. Although the results of this study suggested some benefits for antibiotics intake during the active phase of therapy, these findings need to be confirmed by larger placebo-controlled randomized clinical trials with longer follow-up periods.
authors.affiliation: Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.
authors.forename: Aretuza
authors.initials: A
authors.lastname: Fritoli
authors.affiliation: Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.
authors.forename: Cristiane
authors.initials: C
authors.lastname: Gonçalves
authors.affiliation: Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Faveri
authors.affiliation: Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.
authors.forename: Luciene Cristina
authors.initials: LC
authors.lastname: Figueiredo
authors.affiliation: Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.
authors.forename: Paula Juliana
authors.initials: PJ
authors.lastname: Pérez-Chaparro
authors.affiliation: Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.
authors.forename: Daiane
authors.initials: D
authors.lastname: Fermiano
authors.affiliation: Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.
authors.forename: Magda
authors.initials: M
authors.lastname: Feres
mesh_terms: D000658:Amoxicillin / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D012534:Dental Scaling / Q000379:methods; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage*; D010518:Periodontitis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D000658:Amoxicillin