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Incomplete adherence to an adjunctive systemic antibiotic regimen decreases clinical outcomes in generalized aggressive periodontitis patients: a pilot retrospective study
Author(s) -
Guerrero Adrian,
Echeverría Jose J.,
Tonetti Maurizio S.
Publication year - 2007
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/j.1600-051x.2007.01130.x
Subject(s) - medicine , metronidazole , amoxicillin , regimen , periodontitis , confidence interval , retrospective cohort study , aggressive periodontitis , antibiotics , clinical attachment loss , surgery , gastroenterology , microbiology and biotechnology , biology
Aim: The objective of this study was to explore the effect of incomplete adherence to the prescribed antibiotic regimen, amoxicillin and metronidazole, in the non‐surgical treatment of generalized aggressive periodontitis (GAP). Methods: This retrospective study included 18 GAP subjects who received a conventional course of full‐mouth non‐surgical periodontal treatment using machine‐driven and hand instruments and an adjunctive course of systemic antibiotics (500 mg amoxicillin and 500 mg metronidazole three times a day for 7 days). Clinical parameters were collected at baseline and at 2 months post‐treatment. Self‐reported adherence to the prescribed medication regimen was recorded at 2 months. Results: All clinical parameters, except for the mean clinical attachment level (CAL) in sites with initial probing pocket depth (PPD) 3 mm, improved at 2 months in all subjects. PPD reduction was 3.7 mm [95% confidence interval (CI) 3.2, 4.3 mm] in deep pockets (7 mm) and 2.2 mm (95% CI 1.9, 2.4 mm) in moderate pockets (4–6 mm), while CAL gain was 2.2 mm (95% CI 1.7, 2.6 mm) and 1.2 mm (95% CI 0.8, 1.5 mm), respectively. However, only 11 subjects (61.1%) reported full adherence to the medication. In deep pockets (7 mm), the difference between an adherent and non‐adherent/partially adherent subject was 0.9 mm (95% CI 0.1, 1.7 mm, ancova , p =0.027) in PPD reduction and 0.8 mm (95% CI −0.2, 1.9, p =0.129) in CAL gain at 2 months. In moderate pockets (4–6 mm) this difference was smaller in magnitude: 0.4 mm (95% CI 0.1, 0.9 mm, p =0.036) in PPD reduction and 0.2 mm (95% CI −0.3, 0.9 mm, p =0.332) in CAL gain. Conclusions: Within the limits of this design, these data suggest that incomplete adherence to a 7‐day adjunctive course of systemic metronidazole and amoxicillin is associated with decreased clinical outcomes in subjects with generalized aggressive periodontitis.