Azithromycin in periodontal treatment: more than an antibiotic

A selection of abstracts of clinically relevant papers from other journals. The abstracts on this page have been chosen and edited by John R. Radford.

Abstract

A 'profligate use' of antibiotics or the preferred treatment for those with 'low plaque scores and low responsiveness to periodontal therapy'.

Main

Hirsch R, Deng H et al. J Periodont Res 2012; 47: 137–148

Antibiotics used to treat those who have had a sub-optimal response to conventional periodontal therapies, can be associated with 1) poor compliance, 2) bacterial resistance to the antibiotic(s) and 3) in 40% of patients, side-effects from the antibiotics. Indeed the very use of antibiotics as an adjunct for the treatment of periodontal disease has recently been questioned, as it has been shown that similar outcomes were achieved with mechanical debridement and chlorhexidine. Macrolides, that include azithromycin, not only have antibiotic properties but also immune-modulating/anti-inflammatory effects. Such characteristics may be an explanation for the possible role of azithromycin in the treatment of cyclosporine-induced gingival overgrowth. In addition, azithromycin can penetrate biofilms and has a long antibacterial half-life, even after a single course of three tablets.