Systemic Antibiotics Influence Periodontal Parameters and Oral Microbiota, But Not Serological Markers

Abstract

The use of systemic antibiotics may influence the oral microbiota composition. Our aim was to investigate in this retrospective study whether the use of prescribed antibiotics associate with periodontal status, oral microbiota, and antibodies against the periodontal pathogens. The Social Insurance Institution of Finland Data provided the data on the use of systemic antibiotics by record linkage to purchased medications and entitled reimbursements up to 1 year before the oral examination and sampling. Six different classes of antibiotics were considered. The Parogene cohort included 505 subjects undergoing coronary angiography with the mean (SD) age of 63.4 (9.2) years and 65% of males. Subgingival plaque samples were analysed using the checkerboard DNA-DNA hybridisation. Serum and saliva antibody levels to periodontal pathogens were analysed with immunoassays and lipopolysaccharide (LPS) activity with the LAL assay. Systemic antibiotics were prescribed for 261 (51.7%) patients during the preceding year. The mean number of prescriptions among them was 2.13 (range 1–12), and 29.4% of the prescriptions were cephalosporins, 25.7% penicillins, 14.3% quinolones, 12.7% macrolides or lincomycin, 12.0% tetracycline, and 5.8% trimethoprim or sulphonamides. In linear regression models adjusted for age, sex, current smoking, and diabetes, number of antibiotic courses associated significantly with low periodontal inflammation burden index (PIBI, p < 0.001), bleeding on probing (BOP, p = 0.006), and alveolar bone loss (ABL, p = 0.042). Cephalosporins associated with all the parameters. The phyla mainly affected by the antibiotics were Bacteroidetes and Spirochaetes. Their levels were inversely associated with the number of prescriptions (p = 0.010 and p < 0.001) and directly associated with the time since the last prescription (p = 0.019 and p < 0.001). Significant inverse associations were observed between the number of prescriptions and saliva concentrations of Prevotella intermedia, Tannerella forsythia, and Treponema denticola and subgingival bacterial amounts of Porphyromonas gingivalis, P. intermedia, T. forsythia, and T. denticola. Saliva or serum antibody levels did not present an association with the use of antibiotics. Both serum (p = 0.031) and saliva (p = 0.032) LPS activity was lower in patients having any antibiotic course less than 1 month before sampling. Systemic antibiotics have effects on periodontal inflammation and oral microbiota composition, whereas the effects on host immune responses against the periodontal biomarker species seem unchanged.

O Uso De Antibióticos Como Adjuvante No Tratamento Da Periodontite

“…Concluiu-se que o uso de Metronidazol e Amoxicilina em associação ao tratamento periodontal mecânico foi eficaz em proporcionar a melhora dos níveis de PS. Kopra et al (2021) conduziram um estudo retrospectivo no qual foi investigado o efeito do uso de antibióticos sistêmicos na composição da microbiota oral e estado periodontal. Para isso foram coletados e analisados dados de um estudo finlandês sobre doenças cardíacas que incluiu 5.297 pacientes entre junho de 2006 e março de 2008.…”

“…Redução da perda de NIC foi observada em 4 artigos (PRETZL et al, 2018;MENDES et al, 2020; ARDILA e BEDOYA-GARCÍA, 2022; KARRABI e BAGHANI, 2022). Em uma das revisões, foi observada melhora dos parâmetros de SS e perda óssea (KOPRA et al, 2021).…”

Association between the Mediterranean Diet Index and self-reported Gingival Health Status Indicators in a population of Chilean adults: a cross-sectional study

“…Exclusion criteria were based on well-known biological confounding factors for gingival inflammation such as pregnancy and use of anti-inflammatories or systemic antibiotics. 19 Other potential confounders were included, analyzed, and/or properly adjusted in the final model to achieve greater external validity.…”

Managing Oral Health in the Context of Antimicrobial Resistance

“…Regarding periodontal diseases, the use of systemic antibiotics become popular in aggressive forms of periodontitis or ulcerative periodontal conditions based on the aggressive clinical progression of these diseases. On the one hand, systemic antibiotics do impact periodontal parameters in the short-term without a significant change in serum markers [ 89 , 90 ], and with higher side effects [ 90 ]. However, for long-term follow-up, there is low-certainty evidence that systemic antibiotics could be of help in the treatment of periodontitis [ 91 ].…”