Azithromycin as an adjunct to non-surgical periodontal therapy - a systematic review

O'Rourke, Vincent J. (2016) Azithromycin as an adjunct to non-surgical periodontal therapy - a systematic review. Australian Dental Journal, 62 1: 14-22. doi:10.1111/adj.12448


Author O'Rourke, Vincent J.
Title Azithromycin as an adjunct to non-surgical periodontal therapy - a systematic review
Journal name Australian Dental Journal   Check publisher's open access policy
ISSN 1834-7819
0045-0421
Publication date 2016-08-05
Year available 2016
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1111/adj.12448
Open Access Status Not Open Access
Volume 62
Issue 1
Start page 14
End page 22
Total pages 20
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Subject 3500 Dentistry
Abstract The aim of this study was to investigate the current published work relating to the clinical benefits of the use of systemic azithromycin as an adjunct to non-surgical periodontal therapy. A published work search of PubMed, EMBASE and Cochrane Register of Controlled Trials up to 27 April 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 of narrative synthesis of all relevant studies was a valid method of review. 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). In conclusion, 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.
Formatted abstract
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.
Keyword Antibiotic
azithromycin
non-surgical therapy
periodontal therapy
systematic review
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: HERDC Pre-Audit
School of Dentistry Publications
 
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