Administration of Systemic Antibiotics During Non-surgical Periodontal Therapy-a Consensus Report

Overview

Journal Clin Oral Investig

Specialty Dentistry

Date 2018 Oct 31

PMID 30374830

Citations 43

Authors

B Pretzl

S Salzer

B Ehmke

U Schlagenhauf

B Dannewitz

H Dommisch

P Eickholz

Y Jockel-Schneider

Affiliations

Soon will be listed here.

Abstract

Aim: The aim of this meta-review was to evaluate whether there is a meaningful clinical benefit regarding the use of systemic adjunctive antibiotics in the treatment of patients with periodontitis. Additionally, a consensus regarding possible recommendations for future administration of antibiotics should be reached.

Methods: A structured literature search was performed by two independent investigators focusing on systematic reviews (SR) covering adjunctive systemic antibiosis during non-surgical periodontal therapy. Additionally, recent randomized clinical trials (RCT, July 2015 to July 2017) were searched systematically to update the latest SR. Results were summarized and discussed in a plenary to reach a consensus.

Results: Mostly, systematic reviews and RCTs showed a significant positive effect of adjunctive systematic antibiosis compared to controls. These positive effects gain clinical relevance in patients with severe periodontal disease aged 55 years and younger.

Conclusion: Systemic antibiotics as an adjunct to non-surgical periodontal therapy should be sensibly administered and restrictively used. Only certain groups of periodontitis patients show a significant and clinically relevant benefit after intake of systemic antibiosis during periodontal therapy.

Clinical Relevance: Avoiding antibiotic resistance and possible side effects on the human microbiome should be a focus of dentists and physicians. Thus, a sensible administration of antibiotics is mandatory. This manuscript suggests guidelines for a reasonable use.

Citing Articles

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References

Haag D, Peres K, Balasubramanian M, Brennan D . Oral Conditions and Health-Related Quality of Life: A Systematic Review. J Dent Res. 2017; 96(8):864-874. DOI: 10.1177/0022034517709737. View

Riep B, Edesi-Neuss L, Claessen F, Skarabis H, Ehmke B, Flemmig T . Are putative periodontal pathogens reliable diagnostic markers?. J Clin Microbiol. 2009; 47(6):1705-11. PMC: 2691128. DOI: 10.1128/JCM.01387-08. View

Loos B . Systemic markers of inflammation in periodontitis. J Periodontol. 2005; 76(11 Suppl):2106-15. DOI: 10.1902/jop.2005.76.11-S.2106. View

Ahuja A, Baiju C, Ahuja V . Role of antibiotics in generalized aggressive periodontitis: A review of clinical trials in humans. J Indian Soc Periodontol. 2012; 16(3):317-23. PMC: 3498697. DOI: 10.4103/0972-124X.100903. View

Kaur S, Bright R, Proudman S, Bartold P . Does periodontal treatment influence clinical and biochemical measures for rheumatoid arthritis? A systematic review and meta-analysis. Semin Arthritis Rheum. 2014; 44(2):113-22. DOI: 10.1016/j.semarthrit.2014.04.009. View

Haffajee A, Socransky S, Gunsolley J . Systemic anti-infective periodontal therapy. A systematic review. Ann Periodontol. 2004; 8(1):115-81. DOI: 10.1902/annals.2003.8.1.115. View

Tonetti M, Eickholz P, Loos B, Papapanou P, van der Velden U, Armitage G . Principles in prevention of periodontal diseases: Consensus report of group 1 of the 11th European Workshop on Periodontology on effective prevention of periodontal and peri-implant diseases. J Clin Periodontol. 2015; 42 Suppl 16:S5-11. DOI: 10.1111/jcpe.12368. View

Cionca N, Giannopoulou C, Ugolotti G, Mombelli A . Microbiologic testing and outcomes of full-mouth scaling and root planing with or without amoxicillin/metronidazole in chronic periodontitis. J Periodontol. 2010; 81(1):15-23. DOI: 10.1902/jop.2009.090390. View

Dietrich T, Sharma P, Walter C, Weston P, Beck J . The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease. J Clin Periodontol. 2013; 40 Suppl 14:S70-84. DOI: 10.1111/jcpe.12062. View

10.

Harks I, Koch R, Eickholz P, Hoffmann T, Kim T, Kocher T . Is progression of periodontitis relevantly influenced by systemic antibiotics? A clinical randomized trial. J Clin Periodontol. 2015; 42(9):832-842. PMC: 5054899. DOI: 10.1111/jcpe.12441. View

11.

Roumanas E . The social solution-denture esthetics, phonetics, and function. J Prosthodont. 2009; 18(2):112-5. DOI: 10.1111/j.1532-849X.2009.00440.x. View

12.

Kassebaum N, Bernabe E, Dahiya M, Bhandari B, Murray C, Marcenes W . Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. J Dent Res. 2014; 93(11):1045-53. PMC: 4293771. DOI: 10.1177/0022034514552491. View

13.

Lockhart P, Bolger A, Papapanou P, Osinbowale O, Trevisan M, Levison M . Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association?: a scientific statement from the American Heart Association. Circulation. 2012; 125(20):2520-44. DOI: 10.1161/CIR.0b013e31825719f3. View

14.

Caton J, Armitage G, Berglundh T, Chapple I, Jepsen S, Kornman K . A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Clin Periodontol. 2018; 45 Suppl 20:S1-S8. DOI: 10.1111/jcpe.12935. View

15.

Buset S, Zitzmann N, Weiger R, Walter C . Non-surgical periodontal therapy supplemented with systemically administered azithromycin: a systematic review of RCTs. Clin Oral Investig. 2015; 19(8):1763-75. DOI: 10.1007/s00784-015-1499-z. View

16.

Kaur S, White S, Bartold P . Periodontal disease and rheumatoid arthritis: a systematic review. J Dent Res. 2013; 92(5):399-408. DOI: 10.1177/0022034513483142. View

17.

Lalla E, Papapanou P . Diabetes mellitus and periodontitis: a tale of two common interrelated diseases. Nat Rev Endocrinol. 2011; 7(12):738-48. DOI: 10.1038/nrendo.2011.106. View

18.

Garcia Canas P, Khouly I, Sanz J, Loomer P . Effectiveness of systemic antimicrobial therapy in combination with scaling and root planing in the treatment of periodontitis: a systematic review. J Am Dent Assoc. 2015; 146(3):150-63. DOI: 10.1016/j.adaj.2014.12.015. View

19.

Flemmig T . Periodontitis. Ann Periodontol. 2000; 4(1):32-8. DOI: 10.1902/annals.1999.4.1.32. View

20.

Pradeep A, Singh S, Martande S, B Naik S, N P, Kalra N . Clinical and microbiological effects of levofloxacin in the treatment of chronic periodontitis: a randomized, placebo-controlled clinical trial. J Investig Clin Dent. 2014; 6(3):170-8. DOI: 10.1111/jicd.12091. View