Evaluation of the use of systemic antimicrobial agents by professionals for the treatment of periodontal diseases

Abstract

Aim: To investigate the indication of systemic antimicrobial agents used by dental professionals for treatment of patients affected by periodontal diseases. Methods: Interviews by a questionnaire were held with 225 professionals of different dental specialties and who performed periodontal treatment. Results: Among interviewees, 94% indicated systemic antibiotics as a form of periodontal disease treatment. Their main indication was for periodontal abscesses (80%) followed by aggressive periodontitis (62%) and necrotizing diseases (45%). The most frequently used antibiotics were amoxicillin (81%) and metronidazole (57%). The medications were indicated in association with mechanical therapy by 67% of the professionals. As regards the occasion of indication, 60% indicated systemic antibiotic therapy before and after mechanical periodontal scaling and root planing. Seventy-eight percent of the professionals indicated antibiotics associated with periodontal surgery for access to scaling, and 76% indicated it before and after the surgical procedure. Among the interviewees, 99% took into account systemic involvement for drug administration. Conclusions: It was concluded that a considerable portion of professionals indicate systemic antibiotic-therapy in an incoherent manner and in situations in which there is no indication for antibiotic use, or with ineffective protocols.

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

“…One of the core requirements for a potentially pathogenic community to arise involves the capacity of certain species, termed "keystone pathogens," to modulate the host response in ways that impair immune surveillance and tip the balance from homeostasis to dysbiosis. Keystone pathogens also elevate the virulence of the entire microbial community through interactive communication with accessory pathogens [4].…”

Creación de un cuestionario para describir los hábitos de prescripción de antibióticos de odontólogos en Chile.

“…Siguiendo a Streiner y colegas (14) , para la creación de las preguntas del presente cuestionario de auto-reporte se utilizaron, investigaciones previas, opinión de expertos y entrevistas a informantes claves. Metodologías similares al del presente estudio se han realizado en países como el Reino Unido (6,8,12,24) , Estados Unidos (7) , Noruega (9)(10)(11) , Alemania (25) y Brasil (13) , entre otros. Estos trabajos permitieron identificar una serie de falencias en la indicación, posología, intervalos y duración de la ingesta.…”

“…Se considera que entre un 7 y un 10% de los antibióticos son indicados por los odontólogos (5)(6)(7) y sus hábitos de prescripción han sido evaluados, utilizando cuestionarios de auto-reportes, en países como Reino Unido, Estados Unidos, Noruega, Brasil y Alemania, entre otros (6)(7)(8)(9)(10)(11)(12)(13) . En Chile, a pesar Int.…”

Analysis of the Effectiveness of Periodontitis Treatment Using Antimicrobial Agents

“…However, the latter enhances the immune response, creating a vicious circle [3,8]. Interactions between co-pathogens and key pathogens enhance the virulence of the microbial complex as a whole, the expression of different molecules, including relevant adhesins, cognate receptors, proteolytic enzymes, and proinflammatory surface structures/ ligands on the surface of the host cells and virulent microbiota also enhances the virulence factors of the whole complex to provide a heterotypic, compatible, and proinflammatory microbial effect that leads to the irreversible tissue-destructive reaction of the host organism [20].…”