Azithromycin as an Adjunctive Treatment of Generalized Severe Chronic Periodontitis: Clinical, Microbiologic, and Biochemical Parameters

• Published in: Journal of periodontology (1970) 2012-12, Vol.83 (12), p.1480-1491
• Main Authors: Han, Buket, Emingil, Gülnur, Özdemir, Güven, Tervahartiala, Taina, Vural, Caner, Atilla, Gül, Baylas, Haluk, Sorsa, Timo
• Format: Article
• Language: English
• Subjects: Adult; Analysis of Variance; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; azithromycin; Azithromycin - therapeutic use; Bacteria - drug effects; Biological and medical sciences; Chemotherapy, Adjuvant; Chi-Square Distribution; chronic periodontitis; Chronic Periodontitis - drug therapy; Chronic Periodontitis - enzymology; Chronic Periodontitis - microbiology; Dental Plaque - microbiology; Dental Scaling; Dentistry; DNA, Bacterial - genetics; Double-Blind Method; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Female; gingival crevicular fluid; Gingival Crevicular Fluid - enzymology; Humans; Male; matrix metalloproteinase 8; Matrix Metalloproteinase 8 - analysis; Matrix Metalloproteinase 8 - metabolism; Medical sciences; microbiology; Middle Aged; Non tumoral diseases; Otorhinolaryngology. Stomatology; Periodontal Index; Pharmacology. Drug treatments; Statistics, Nonparametric
• ISSN: 0022-3492; 1943-3670
• DOI: 10.1902/jop.2012.110519

Background: This study examines the efficacy of azithromycin in combination with non‐surgical periodontal therapy on clinical and microbiologic parameters and gingival crevicular fluid (GCF) matrix metalloproteinases‐8 (MMP‐8) levels over 6 months in patients with severe generalized chronic periodontitis (CP). Methods: Twenty‐eight of 36 patients with severe generalized CP were included in this randomized, double‐masked, placebo‐controlled, parallel‐arm study. They were randomly assigned to azithromycin or placebo groups (500 mg, once daily for 3 days). Probing depth (PD), clinical attachment level, dichotomous presence or absence of supragingival plaque accumulation, and bleeding on probing were recorded. GCF samples were obtained from one single‐rooted tooth with PD ≥ 6 mm, whereas microbiologic samples were collected from two single‐rooted teeth with PD ≥ 6 mm. Microbiologic parameters were analyzed by quantitative real‐time polymerase chain reaction for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium nucleatum, Prevotella intermedia, and total bacteria. GCF MMP‐8 levels were determined by immunofluorescence assay. Results: Azithromycin and placebo groups demonstrated similar but significant improvements in all clinical parameters (P