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ANTIBIOTICS: SYSTEMIC DELIVERY

Korman, K.S. et al: The Influence of Supragingival Plaque Control on Clinical and Microbial outcomes Following the Use of Antibiotics for the Treatment of Periodontitis. J Perio, 65:848-854, 1994.

Purpose:

To determine which diagnostic and therapeutic factors provide the most predictable treatment outcomes in the management of specific patients with periodontitis

Materials and Methods:

A total of 250 patients from private practices with at least 3 month follow-ups after antibiotic therapy with moderate to severe periodontitis were included in this study. Clinical parameters measured included: Plaque index (PI), bleeding on probing (BOP), probing depth (PD), and bone loss as seen in the x-ray.

Plaque samples taken from most severe tooth that was not to be extracted. Patients had scaling and root planing and assigned one of the antibiotics: amoxicillin 250 mg 3 times/day + metronidazole 3 times/day, augmentin 3 times/day, metronidazole 250 mg 3 times/day, doxycycline 100 mg 2 times/day.

Chlorhexidine rinses

Microbiologic testing pre and post (3 months) antibiotic therapy at baseline and at 3 months.

Patients were subdivided into high plaque (HiPl) and low plaque (LoPl) groups.

Results:

The LoPl group had significant reduction in plaque scores but the high group had minimal change. The LoPl had greater reduction in BOP than HiPl. The reduction in the number of pockets >5 mm were not different between groups. A. a., Pi and E. c. were reduced by antibiotic therapy independent on plaque control. Campylobacter rectus and Capnocytophaga reduced substantially only with LoPl. P. g . was the microbial marker of BOP. High plaque levels and detectable A. a. , P. g. or P. i. or combination showed less improvement by the number of PD > 5 mm

Conclusion:

This study demonstrates that supragingival plaque control is essential factor in clinical and microbial outcomes following systemic antibiotics 
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