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阿奇霉素作为牙周炎非手术牙周治疗辅助疗法的临床疗效:一项系统评价与荟萃分析

Clinical Efficacy of Azithromycin as an Adjunctive Therapy to Non-Surgical Periodontal Treatment of Periodontitis: A Systematic Review and Meta-Analysis.

作者信息

Renatus Antonio, Herrmann Jörg, Schönfelder Antje, Schwarzenberger Fabian, Jentsch Holger

机构信息

Faculty, Department of Cariology, Endodontology and Periodontology, Centre for Periodontology, University Hospital of Leipzig , Leipzig, Germany .

Student, Department of Cariology, Endodontology and Periodontology, Centre for Periodontology, University Hospital of Leipzig , Leipzig, Germany .

出版信息

J Clin Diagn Res. 2016 Jul;10(7):ZE01-7. doi: 10.7860/JCDR/2016/20176.8115. Epub 2016 Jul 1.

DOI:10.7860/JCDR/2016/20176.8115
PMID:27630968
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5020305/
Abstract

INTRODUCTION

Over the years, numerous trials have sufficiently documented benefits of adjuvant administration of antibiotics in combination to Scaling and Root Planing (SRP) in treatment of periodontitis. Nevertheless there are justified doubts in respect to antibiotics administration with regard to increasing development of resistances.

AIM

The aim of this review study and meta-analysis was to verify a possible benefit of Azithromycin (AZM) as an alternative adjuvant antibiotic in combination with SRP.

MATERIALS AND METHODS

Electronic databases (Pubmed) were searched from the earliest point of record until May 2015. A hand search was also conducted. The variables considered in this respect were Probing Depth (PD), Clinical Attachment Level (CAL), Bleeding on Probing (BOP) and SRP. A meta-analysis containing trials comparing SRP as a sole therapy with SRP and administration of AZM was produced once all of the data obtained had been reviewed.

RESULTS

Six randomised clinical trials were accepted into the review and the meta-analysis following the process of trial selection. Meta-analysis revealed larger overall effects by the systemic administration of AZM compared with SRP on their own in terms of PD, CAL, BOP, Plaque-Index and total bacterial load reduction after three and six months.

CONCLUSION

The data used in this study revealed that the systemic administration of AZM is beneficial compared with SRP on its own for the treatment of chronic periodontitis.

摘要

引言

多年来,大量试验充分证明了在牙周炎治疗中,辅助使用抗生素与龈下刮治术和根面平整术(SRP)联合应用的益处。然而,对于抗生素的使用,人们对耐药性增加的问题存在合理的疑虑。

目的

本综述研究和荟萃分析的目的是验证阿奇霉素(AZM)作为替代辅助抗生素与SRP联合使用的可能益处。

材料和方法

检索电子数据库(PubMed),从记录最早时间至2015年5月。同时进行手工检索。在此方面考虑的变量有探诊深度(PD)、临床附着水平(CAL)、探诊出血(BOP)和SRP。在对所有获得的数据进行审查后,进行了一项荟萃分析,该分析包含比较SRP单一疗法与SRP联合使用AZM的试验。

结果

在试验选择过程之后,六项随机临床试验被纳入综述和荟萃分析。荟萃分析显示,在三个月和六个月后测量的PD、CAL、BOP、菌斑指数和总细菌负荷降低方面,与单独使用SRP相比,全身应用AZM具有更大的总体效果。

结论

本研究中使用的数据表明,与单独使用SRP相比,全身应用AZM对慢性牙周炎的治疗有益。

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本文引用的文献

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Non-surgical periodontal therapy supplemented with systemically administered azithromycin: a systematic review of RCTs.非手术牙周治疗联合全身应用阿奇霉素:随机对照试验的系统评价
Clin Oral Investig. 2015 Nov;19(8):1763-75. doi: 10.1007/s00784-015-1499-z. Epub 2015 Jun 12.
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Non-surgical periodontal therapy with systemic antibiotics in patients with untreated aggressive periodontitis: a systematic review and meta-analysis.未经治疗的侵袭性牙周炎患者使用全身抗生素进行非手术牙周治疗:一项系统评价和荟萃分析。
J Periodontal Res. 2015 Dec;50(6):689-706. doi: 10.1111/jre.12252. Epub 2014 Dec 18.
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Local drug delivery of 0.5% azithromycin in the treatment of chronic periodontitis among smokers.局部给予 0.5%阿奇霉素治疗吸烟慢性牙周炎。
Aust Dent J. 2013 Mar;58(1):34-40. doi: 10.1111/adj.12019. Epub 2013 Jan 30.
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Local and systemic antimicrobial therapy in periodontics.牙周病的局部和全身抗菌治疗。
J Evid Based Dent Pract. 2012 Sep;12(3 Suppl):50-60. doi: 10.1016/S1532-3382(12)70013-1.
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Effect of azithromycin, as an adjunct to nonsurgical periodontal treatment, on microbiological parameters and gingival crevicular fluid biomarkers in generalized aggressive periodontitis.阿奇霉素辅助非手术牙周治疗对广泛性侵袭性牙周炎患者微生物参数和龈沟液生物标志物的影响。
J Periodontal Res. 2012 Dec;47(6):729-39. doi: 10.1111/j.1600-0765.2012.01488.x. Epub 2012 May 9.
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J Clin Periodontol. 2011 Sep;38(9):838-46. doi: 10.1111/j.1600-051X.2011.01766.x. Epub 2011 Jul 19.
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