Influence of adjunctive azithromycin on microbiological and
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This research was sought to ascertain whether azithromycin therapy, as an adjunct to scaling and root planing (SRP), reduces the number of pathobiontic subgingival plaque species and sites demonstrating pocket depth (PD) 5 mm and bleeding on probing (BOP) 6 months post-treatment. Researchers designed a double-blind randomized parallel-arm placebo-controlled trial including a total of 40 patients who received nonsurgical periodontal treatment in two sessions within 7 days. The impacts of gender, age, antibiotic therapy, presence of P. gingivalis or A. actinomycetemcomitans, smoking, the tooth being a molar, and interdental location were evaluated applying multivariate multilevel logistic regression. Individuals with periodontitis do not benefit from adjunctive systemic azithromycin in terms of the number of persisting sites with PD 5 mm and BOP, despite significant changes in numbers of A. actinomycetemcomitans, P. gingivalis, and C. rectus.

To summarize, in comparison to SRP, the systemic use of azithromycin as an adjunct to SRP decreased the proportion and total counts of P. gingivalis, decreased the proportion of C. rectus, and resulted in more frequent eradication of A. actinomycetemcomitans and C. rectus. Its use showed significant improvements in periodontal parameters and the number of residual disease sites (sites with PD 5 mm and BOP) 6-months after treatment, which was, however, equivalent to subjects who were treated with SRP alone. Irrespective of treatment type, 90% of diseased sites were healed in more than half of the subjects. A lower odds ratio was found for the healing of sites on molars. It can therefore be concluded that the empiric use of azithromycin in the treatment of generalized stage III/IV periodontitis is unfounded.