Local drug delivery of 0.5% azithromycin in the treatment of chronic periodontitis among smokers

Aust Dent J. 2013 Mar;58(1):34-40. doi: 10.1111/adj.12019. Epub 2013 Jan 30.

Abstract

Background: Along with conventional periodontal surgical therapy, local delivery of antibiotics may provide more effective treatment in smokers by targeting tissue-invasive bacteria. The aim of this randomized, placebo-controlled, double-masked clinical trial was to evaluate the adjunctive effects of subgingivally delivered 0.5% azithromycin (AZM) as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis in smokers.

Methods: Fifty-four patients were randomized and categorized into two treatment groups: Group 1 - 26 subjects who received (SRP) plus placebo gel and Group 2 - 28 subjects who received (SRP) plus 0.5% azithromycin. Clinical parameters were recorded at baseline, 3, 6 and 9 months. They included Plaque Index (PI), modified Sulcus Bleeding Index (mSBI), probing depth (PD) and clinical attachment level (CAL).

Results: Azithromycin resulted in significant improvements. A single application of AZM resulted in attachment gain at 9 months of 2.44 ± 0.64 mm as compared to 0.18 ± 0.68 mm for the placebo. Similarly, pocket depth and PI were significantly reduced but no change in the mSBI was noted.

Conclusions: When compared to the placebo, the adjunctive use of 0.5% AZM resulted in significant improvement in clinical outcome in the treatment of chronic periodontitis among smokers.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Anti-Bacterial Agents / administration & dosage*
  • Azithromycin / administration & dosage*
  • Chemotherapy, Adjuvant / methods
  • Chronic Periodontitis / therapy*
  • Dental Scaling / methods
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Gels
  • Humans
  • Male
  • Periodontal Index
  • Root Planing / methods
  • Smoking*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Gels
  • Azithromycin