Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia.
Nova Gorica Health Centre, 5000, Nova Gorica, Slovenia.
BMC Oral Health. 2020 Sep 1;20(1):241. doi: 10.1186/s12903-020-01209-0.
Our aim was to determine if azithromycin therapy, as an adjunct to scaling and root planing (SRP), decreases the number of pathobiontic subgingival plaque species and sites demonstrating pocket depth (PD) ≥ 5 mm and bleeding on probing (BOP) 6 months post-treatment.
In a double-blind randomized parallel-arm placebo-controlled trial, 40 patients received nonsurgical periodontal treatment in two sessions within 7 days. Patients then received systemic antibiotic therapy (n = 20, azithromycin 500 mg/day for 3 days) or placebo (n = 20). Pooled microbiologic samples were taken before and 6 months after therapy and analysed by established culture methods. The primary outcome variable was the number of sites with PD ≥ 5 mm and BOP at the 6-month re-evaluation. Using multivariate multilevel logistic regression, the effects of gender, age, antibiotic therapy, presence of P. gingivalis or A. actinomycetemcomitans, smoking, tooth being a molar and interdental location were evaluated.
The number of sites with PD ≥ 5 mm and BOP after 6 months was similar in the test (Me = 4, IQR = 0-11) and control (Me = 5, IQR = 1-22) group. Adjunctive azithromycin treatment, compared to SRP alone, resulted in more frequent eradication of A. actinomycetemcomitans (p = 0.013) and C. rectus (p = 0.029), decreased proportion (p = 0.006) and total counts (p = 0.003) of P. gingivalis, and decreased proportion of C. rectus (p = 0.012). Both groups showed substantial but equivalent improvements in periodontal parameters, with no intergroups differences at initially shallow or deep sites. The logistic regression showed a lower odds ratio for healing of diseased sites on molars (OR = 0.51; p < 0,001).
Despite significant changes in numbers of A. actinomycetemcomitans, P. gingivalis and C. rectus, patients with periodontitis do not benefit from adjunctive systemic azithromycin in terms of number of persisting sites with PD ≥ 5 mm and BOP.
EUDRA-CT: 2015-004306-42; https://www.clinicaltrialsregister.eu/ctr-search/trial/2015-004306-42/SI , registered 17. 12. 2015.
我们的目的是确定在辅助性牙周治疗中（辅助性龈下刮治和根面平整术），阿奇霉素治疗是否能减少致病亚群落龈下斑块的数量和牙周袋深度（PD）≥5mm 和探诊出血（BOP）的位点数量，6 个月后治疗后。
在一项双盲随机平行臂安慰剂对照试验中，40 名患者在 7 天内分两次接受非手术牙周治疗。然后，患者接受全身抗生素治疗（n=20，阿奇霉素 500mg/天，连续 3 天）或安慰剂（n=20）。在治疗前和 6 个月后采集混合微生物样本，并采用已建立的培养方法进行分析。主要结局变量是在 6 个月的重新评估时 PD≥5mm 和 BOP 的位点数量。使用多变量多级逻辑回归，评估了性别、年龄、抗生素治疗、是否存在牙龈卟啉单胞菌或伴放线放线杆菌、吸烟、牙齿为磨牙和牙间隙位置的影响。
在 6 个月后，试验组（中位数=4，IQR=0-11）和对照组（中位数=5，IQR=1-22）的 PD≥5mm 和 BOP 位点数量相似。与单独的 SRP 相比，辅助性阿奇霉素治疗导致伴放线放线杆菌（p=0.013）和直肠弯曲菌（p=0.029）的清除率更高，牙龈卟啉单胞菌的比例（p=0.006）和总计数（p=0.003）降低，直肠弯曲菌的比例（p=0.012）降低。两组患者牙周参数均有明显改善，但无组间差异，在初始浅或深部位无差异。逻辑回归显示磨牙上疾病部位愈合的优势比较低（OR=0.51；p<0.001）。
尽管 A. actinomycetemcomitans、P. gingivalis 和 C. rectus 的数量发生了显著变化，但牙周炎患者并未从辅助性全身阿奇霉素治疗中获益，在 PD≥5mm 和 BOP 持续存在的位点数量方面没有获益。
EUDRA-CT：2015-004306-42；https://www.clinicaltrialsregister.eu/ctr-search/trial/2015-004306-42/SI，2015 年 12 月 17 日注册。
