Aim The aim of this study was to investigate the current literature relating to the clinical benefits of the use of systemic azithromycin as an adjunct to non-surgical periodontal therapy.
Materials and Methods A literature search of PubMed, EMBASE and Cochrane up to April 27, 2016 was undertaken. The large degree of heterogeneity in the types of studies, treatment protocols, test subjects, sample size and exclusion criteria indicated that the use narrative synthesis of all relevant studies as a valid method of review.
Results Of the 194 eligible studies 15 were found to be of relevance. The majority of studies demonstrated an additional clinical benefit when azithromycin is used as an adjunct to non-surgical periodontal therapy particularly in deeper pockets (≥6 mm).
Conclusions The current body of research on the adjunctive use of systemic azithromycin in non-surgical periodontal therapy suggests there is a clinical benefit and that this benefit is greatest in deeper initial pockets (≥6 mm). The findings also suggest that future studies need to be more careful in subject selection to identify susceptible patients or at risk sites, both the immunoregulatory effects and antibiotic resistance of azithromycin needs to be reported, and that study populations need to be more homogeneous.