title: Nonsurgical therapy of chronic periodontitis with adjunctive systemic azithromycin or amoxicillin/metronidazole.
abstract: OBJECTIVE
  The objective of the present study is to compare the effect of systemic adjunctive use of azithromycin with amoxicillin/metronidazole to scaling and root planing (SRP) in a clinical study.
  
  
  METHODS
  Data from 60 individuals with chronic periodontitis were evaluated after full-mouth SRP. Antibiotics were given from the first day of SRP, in the test group (n = 29), azithromycin for 3 days and, in the control group (n = 31), amoxicillin/metronidazole for7 days. Probing depth (PD), attachment level (AL), and bleeding on probing (BOP) were recorded at baseline and after 3 and 12 months. Gingival crevicular fluid was analyzed for matrix metalloprotease (MMP)-8 and interleukin (IL)-1beta levels. Subgingival plaque was taken for assessment of the major bacteria associated with periodontitis.
  
  
  RESULTS
  In both groups, PD, AL, and BOP were significantly reduced (p < 0.001). A few significant differences between the groups were found; AL and BOP were significantly better in the test than in the control group at the end of the study (p = 0.020 and 0.009). Periodontopathogens were reduced most in the test group.
  
  
  CONCLUSIONS
  A noninferiority of the treatment with azithromycin in comparison with amoxicillin/metronidazole can be stated. The administration of azithromycin could be an alternative to the use of amoxicillin/metronidazole adjunctive to SRP in patients with moderate or severe chronic periodontitis; however, a randomized placebo-controlled multicenter study is needed.
  
  
  CONCLUSIONS
  Application of azithromycin as a single antibiotic for 3 days might be considered as an additional adjunctive antibiotic to SRP in selected patients.
authors.affiliation: Centre for Periodontology, Department of Cariology, Endodontology and Periodontology, University Hospital of Leipzig, Liebigstr. 12, Haus 1, 04103, Leipzig, Germany. jenh@medizin.uni-leipzig.de.
authors.forename: Holger F R
authors.initials: HF
authors.lastname: Jentsch
authors.affiliation: Private dental practice, Weiskirchen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Buchmann
authors.affiliation: Private dental practice, Weiskirchen, Germany.
authors.forename: Abel
authors.initials: A
authors.lastname: Friedrich
authors.affiliation: Department of Periodontology, Laboratory of Oral Microbiology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Sigrun
authors.initials: S
authors.lastname: Eick
mesh_terms: D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D055113:Chronic Periodontitis / Q000382:microbiology / Q000628:therapy*; D012534:Dental Scaling; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D010512:Periodontal Index; D016745:Root Planing; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D008795:Metronidazole; D000658:Amoxicillin; D017963:Azithromycin
keywords: Antibiotics; Chronic periodontitis; Cytokines; Periodontopathogens; Scaling and root planing