A double-blind placebo-controlled trial of azithromycin as an adjunct to non-surgical treatment of periodontitis in adult : clinical results

Aim of the study

This two-part study aimed to evaluate the efficacy of the latest generation macrolide on microbiological and clinical parameters when used as an adjunct in the non-surgical treatment of chronic periodontitis. The part presented here reports the clinical results.

Materials and methods

Forty-six patients in good general health, presenting with chronic periodontitis, were entered for the study and examined at weeks 1, 2, 3, 6, 10 and 22. The clinical indices measured were : plaque, bleeding, calculus and probing depth. Microbiological sampling was undertaken on each occasion. One group received the antibiotic (500 mg/day for 3 days) in addition to scaling and root planing at weeks 0, 1 and 2. The other group received the placebo.

Results

Forty-four patients completed the trial. The clinical indices such as PlI, BlI and CI were not significantly different between the groups throughout the trial. The percentage of pockets that did not improve or which became deeper towards the end of the trial was significantly higher in the placebo group. The percentage of pockets < 4 mm was higher in the test group. The percentage of deep pockets at the end of the study was greater in the placebo group.

Conclusion

Azithromycin is an effective adjunct in the non-surgical treatment of chronic periodontitis, particularly where deep pockets are present.

Commentary

This appears to be the first clinical trial of this antibiotic. The bibliography seems to show azithromycin to be more effective than metronidazole. We await the microbiological results to add to the clinical results. Further studies will be needed to confirm the results of this first trial.