Objectives: To compare the effect of systemic adjunctive use of azithromycin with amoxicillin/metronidazole to scaling and root planing (SRP) in a clinical study. Materials and 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 three days, in the control group (n=31) amoxicillin/metronidazole for seven 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 MMP-8 and 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. Clinical Relevance: Application of azithromycin as a single antibiotic for three days might be considered as an additional adjunctive antibiotic to SRP in selected patients.
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