Evaluating the effectiveness of clarithromycin as an adjunct to scaling and root planing: A randomized clinical trial

Abstract

Background:Administration of systemic antibiotics may implement persuasive treatment effect for chronic periodontitis by intending tissue-invasive bacteria in addition to accustomed nonsurgical periodontal therapy (NSPT).Aims:The aim of this study was to assess the ancillary effects of oral clarithromycin (CLM) along with NSPT for chronic periodontitis.Materials and Methods:Thirty periodontitis patients were randomly divided into two equal groups in this double-blind, randomized, parallel group, and active-controlled trial: test group – scaling and root planning (SRP) plus CLM (500 mg thrice daily for 7 days, orally) was given, and control group – only SRP was done. Clinical analysis, such as gingival index (GI), probing depth (PD), and clinical attachment loss (CAL), were taken at baseline, 3 months, and 6-month intervals for both groups. Subgingival plaque samples were cultured for periodontopathic organisms. Immunological parameter C-reactive protein (CRP) levels were estimated.Results:SPSS version 14 was used for statistical analysis. The intragroup comparison showed a significant reduction in the mean scores of all the parameters from baseline to 6 months. The intergroup comparison showed a statistically significant reduction of PD from baseline to 3 months (P < 0.001). GI, CAL, and CRP levels were also reduced but not statistically significant. The mean colony-forming units (CFU) of Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) showed a statistically significant reduction from baseline to 3 months only in the test group (P = 0.042) and (P = 0.046), respectively. There was no statistically significant reduction of Aa and Pg at 6 months.Conclusions:CLM conceivably accepted as an addendum to NSPT for a shorter period.

Adjunctive systemic antimicrobials in the treatment of chronic periodontitis: A systematic review and network meta‐analysis

“…A total of 18 756 citations were found during the electronic and manual search; after reviewing title and abstract, 451 studies were considered as relevant and were further screened ( κ = 0.84). Of these, 106 papers were evaluated for the full‐text examination ( κ = 0.91): Finally, 85 studies were excluded ( κ = 0.98), since they did not satisfy the eligibility criteria (Table ), and the remaining 21 28‐48 studies were included in the systematic review.…”

“…The population consisted of 1344 subjects, with an age range of 32‐66 years. Smoking was considered as an exclusion criterion in nine studies, 28,29,31,32,37,38,42,44,47 while in one paper 43 no information was reported; smoking habit was defined in three 30,36,40 out of the eleven studies that reported the inclusion of smokers. Nine different antimicrobials with a wide range of dosage and duration were analyzed in the included trials; in addition, discrepancies in the SRP approach were also retrieved, since twelve RCTs 28,29,32,33,35,36,38‐41,46,48 performed a staged mechanical treatment, while four RCTs 30,31,34,35 adopted a full‐mouth approach.…”

“…Nine different antimicrobials with a wide range of dosage and duration were analyzed in the included trials; in addition, discrepancies in the SRP approach were also retrieved, since twelve RCTs 28,29,32,33,35,36,38‐41,46,48 performed a staged mechanical treatment, while four RCTs 30,31,34,35 adopted a full‐mouth approach. The studies varied also in the instrumentation used to perform SRP: Nine studies 28,33,35‐37,43,44,47,48 did not report any information about the type of instrument used, while three papers 32,38,46 reported that SRP was performed with only manual instrumentation; three trials employed only mechanical instruments, 31,41,42 while six studies 29,30,34,39,40,45 adopted a combined manual and mechanical instrumentation. Five RCTs did not report the use of placebo in the control group.…”

Antibiotics in the Treatment of Periodontitis: A Systematic Review of the Literature

“…Clinical trials comprised 524 participants. Studies included a minimum of 30 [15] up to 180 [10] subjects.…”

“…e target population included generalized aggressive periodontitis (GAgP) in two studies [13,16], chronic periodontitis (CP) in three studies [12,14,15], and moderate-to-severe periodontitis in two studies [10,11]. e subgingival debridement regime ranged from a full-mouth approach in one session [13,16] to a staged approach over 14 days [11,12,14].…”