Azithromycin Concentrations in Blood and Gingival Crevicular Fluid After Systemic Administration

Lai, Pin‐Chuang; Ho, Wei‐Ting; Jain, Nidhi; Walters, John D.

doi:10.1902/jop.2011.110012

Cited by 32 publications

(36 citation statements)

References 35 publications

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“…Since A. actinomycetemcomitans exhibits strain-dependent differences in susceptibility to AZM, the effects of AZM on two different invasive strains were examined. Infected SG epithelial cells were treated with AZM concentrations similar to those found in blood (0.125 to 0.5 g/ml) and GCF (2 to 8 g/ml) (27). AZM produced dose-and time-dependent intraepithelial killing of both strains ( Fig.…”

Section: Resultsmentioning

confidence: 86%

Azithromycin Kills Invasive Aggregatibacter actinomycetemcomitans in Gingival Epithelial Cells

Lai

Walters

2013

Antimicrob Agents Chemother

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Section: Resultsmentioning

confidence: 86%

Azithromycin Kills Invasive Aggregatibacter actinomycetemcomitans in Gingival Epithelial Cells

Lai

Walters

2013

Antimicrob Agents Chemother

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“…We identified the 1:27 dilutions as being of primary interest because they corresponded to levels obtained in gingival crevicular fluid (GCF) with the systemic use of these agents, i.e., 4, 10, and 8 g/ml for AMX, MTZ, and AZM, respectively (40)(41)(42). However, we also tested higher concentrations to examine whether they had increased efficacy.…”

Section: Susceptibility Of In Vitro Biofilms To Antibioticsmentioning

confidence: 99%

Effects of Azithromycin, Metronidazole, Amoxicillin, and Metronidazole plus Amoxicillin on anIn VitroPolymicrobial Subgingival Biofilm Model

Soares

Teles

Starr

et al. 2015

Antimicrob Agents Chemother

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dChronic periodontitis is one of the most prevalent human diseases and is caused by dysbiosis of the subgingival microbiota. Treatment involves primarily mechanical disruption of subgingival biofilms and, in certain cases, adjunctive use of systemic antibiotic therapy. In vitro biofilm models have been developed to study antimicrobial agents targeting subgingival species. However, these models accommodate a limited number of taxa, lack reproducibility, and have low throughput. We aimed to develop an in vitro multispecies biofilm model that mimics subgingival plaque, to test antimicrobial agents. Biofilms were cultivated using the Calgary Biofilm Device and were exposed to amoxicillin (AMX), metronidazole (MTZ), azithromycin (AZM), and AMX-MTZ at four different concentrations for 12, 24, or 36 h. Chlorhexidine (CHX) (0.12%) was used as the positive control. The compositions of the biofilms were analyzed by checkerboard DNA-DNA hybridization, and the percent reduction in biofilm metabolic activity was determined using 2,3,5-triphenyltetrazolium chloride and spectrophotometry. Thirty-five of the 40 species used in the inoculum were consistently recovered from the resulting in vitro biofilms. After 36 h of exposure at the 1:27 dilution, AMX-MTZ reduced metabolic activity 11% less than CHX (q ‫؍‬ 0.0207) but 54% more than AMX (q ‫؍‬ 0.0031), 72% more than MTZ (q ‫؍‬ 0.0031), and 67% more than AZM (q ‫؍‬ 0.0008). Preliminary evidence of a synergistic interaction between AMX and MTZ was also observed. In summary, we developed reproducible biofilms with 35 subgingival bacterial species, and our results suggested that the combination of AMX and MTZ had greater antimicrobial effects on these in vitro multispecies biofilms than expected on the basis of the independent effects of the drugs. P eriodontitis is a persistent health problem that affects the U.S. population in epidemic proportions. The most recent data from the National Health and Nutrition Examination Survey (NHANES) (2009 to 2010) suggest that the prevalence of chronic periodontitis among U.S. adults is over 47%, representing 64.7 million adults (1). Chronic periodontitis is the main cause of tooth loss in adults. Treatment costs U.S. taxpayers $4.4 billion each year (2), but existing therapies do not eradicate the disease. Frequent posttreatment follow-up visits are needed and are costly, which may be one reason why the prevalence is higher in populations of low socioeconomic status (3).A single periodontal pocket harbors a complex polymicrobial community of up to hundreds of taxa, and periodontal diseases are triggered by dysbiosis of subgingival organisms. Organization of the subgingival microbiota in biofilms makes it challenging to control periodontal infections, since biofilms help protect resident organisms from both antimicrobial agents and immune mechanisms (4). Still, the use of systemic and local antibiotics as an adjunct to mechanical treatment provides clinical benefit beyond that achieved by scaling and root planing alone (5-15).However, the threa...

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“…Lai et al measured steady-state levels of azithromycin in gingival crevicular fluid (GCF) and reported that the concentrations in GCF were higher and more sustained than those in serum. They suggested that the pharmacokinetic profiles of azithromycin are different in GCF and serum 6) . It was also reported that azithromycin attenuates acute and chronic tissue inflammation 4,5,9,10) .…”

Section: Discussionmentioning

confidence: 99%

“…Azithromycin is known as an effective antibiotic in the treatment of odontogenic infections, 6) and the administration of a single large dose of azithromycin as front-loading achieves more rapid bacterial eradication and prophylaxis of postoperative infections including prevention of infective endocarditis 7,8) .…”

Section: Introductionmentioning

confidence: 99%

Effect of single-dose extended-release oral azithromycin on anticoagulation status in warfarinized patients

Kusafuka

Kitamura

Sakurai

et al. 2013

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Objective: To investigate the possible influence of single-dose 2.0 g azithromycin (AZ-ER) on anticoagulation in patients taking warfarin.Study design: Eighteen consecutive patients receiving long-term stable warfarin therapy were enrolled in this study. AZ-ER was administered 1-hour prior to tooth extraction.The International Normalized Ratio (INR) value was measured prior to AZ-ER administration, during, one-day after, and seven-days after the tooth extraction.Additionally, the azithromycin concentration in the extraction wound as well as in peripheral venous blood was assessed.Results: The changes in INR throughout the study period were not statistically significant (two-factor ANOVA, N.S.). The azithromycin concentration in extraction wounds was higher than that in peripheral veins. Conclusion:The results of this study suggest that prophylactic administration of AZ-ER to patients receiving daily warfarin therapy with a stable coagulation status has no relevant effect on the anticoagulant effect of warfarin.3

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Azithromycin Concentrations in Blood and Gingival Crevicular Fluid After Systemic Administration

Cited by 32 publications

References 35 publications

Azithromycin Kills Invasive Aggregatibacter actinomycetemcomitans in Gingival Epithelial Cells

Azithromycin Kills Invasive Aggregatibacter actinomycetemcomitans in Gingival Epithelial Cells

Effects of Azithromycin, Metronidazole, Amoxicillin, and Metronidazole plus Amoxicillin on anIn VitroPolymicrobial Subgingival Biofilm Model

Effect of single-dose extended-release oral azithromycin on anticoagulation status in warfarinized patients

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