title: Systemic antimicrobials adjuvant to periodontal therapy in diabetic subjects: a meta-analysis.
abstract: BACKGROUND
  Adjuvant antibiotics have been suggested to improve periodontal therapy in diabetic subjects.
  
  
  OBJECTIVE
  The aim of this study was to systematically review randomized clinical trials assessing systemic antimicrobial use adjuvant to scaling and root planing (SRP) versus SRP alone in diabetic subjects.
  
  
  METHODS
  The PubMed, Cochrane Central Register of Controlled Trials, EMBASE, TRIP, Web of Science and LILACS databases and the grey literature were searched through May 2015. Of 2534 potentially eligible studies, 13 were included in the systematic review. Weighted mean differences (WMDs) in probing depth (PD) reduction and clinical attachment level (CAL) gain (primary outcomes), and plaque index (PI) and bleeding on probing (BOP) reductions, were estimated using a random effect model.
  
  
  RESULTS
  The WMD in PD reduction [-0.15 mm, n = 11, p = 0.001, 95% confidence interval (CI) -0.24, -0.06] favoured antibiotic use. WMDs in CAL gain, PI and BOP reductions (-0.14 mm, n = 9, p = 0.11, 95% CI -0.32, 0.03; 4.01%, n = 7, p = 0.05, 95% CI -0.04, 8.07; and -1.91%, n = 7, p = 0.39, 95% CI -6.32, 2.51 respectively) did not favour adjunctive antibiotic use.
  
  
  CONCLUSIONS
  Adjunctive therapy may improve the efficacy of SRP in reducing PD in diabetic subjects.
authors.affiliation: Post-graduate Program in Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.
authors.forename: Alessandra Pascotini
authors.initials: AP
authors.lastname: Grellmann
authors.affiliation: Post-graduate Program in Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.
authors.forename: Camila Silveira
authors.initials: CS
authors.lastname: Sfreddo
authors.affiliation: Post-graduate Program in Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.
authors.forename: Juliana
authors.initials: J
authors.lastname: Maier
authors.affiliation: Post-graduate Program in Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.
authors.forename: Tathiane Larissa
authors.initials: TL
authors.lastname: Lenzi
authors.affiliation: Post-graduate Program in Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.
authors.forename: Fabricio Batistin
authors.initials: FB
authors.lastname: Zanatta
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D012534:Dental Scaling; D003920:Diabetes Mellitus / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000188:drug therapy; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000188:drug therapy; D016745:Root Planing
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents
keywords: amoxicillin; antibiotic; azithromycin; chronic periodontitis; clavulanic acid; diabetes mellitus; doxycycline; metronidazole; periodontal disease; periodontal therapy