Metronidazole and amoxicillin as adjuncts to scaling and root planing for the treatment of type 2 diabetic subjects with periodontitis: 1-year outcomes of a randomized placebo-controlled clinical trial

• Published in: Journal of clinical periodontology Vol. 41; no. 9; pp. 890 - 899
• Main Authors: Miranda, Tamires Szeremeske, Feres, Magda, Perez-Chaparro, Paula Juliana, Faveri, Marcelo, Figueiredo, Luciene Cristina, Tamashiro, Neila Sumie, Bastos, Marta Ferreira, Duarte, Poliana Mendes
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.09.2014
• Subjects: Adult; Aged; amoxicillin; Amoxicillin - administration & dosage; Anti-Bacterial Agents - administration & dosage; Anti-Infective Agents - administration & dosage; Antibiotics; Biofilms - drug effects; chronic periodontitis; Chronic Periodontitis - complications; Chronic Periodontitis - microbiology; Chronic Periodontitis - therapy; Clinical outcomes; Combined Modality Therapy; Dental Plaque - microbiology; dental scaling; Dental Scaling - methods; Dentistry; Diabetes; diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Double-Blind Method; Drug Combinations; Eubacterium - drug effects; Eubacterium - isolation & purification; Female; Follow-Up Studies; Gum disease; Humans; Male; metronidazole; Metronidazole - administration & dosage; Middle Aged; Periodontal Attachment Loss - microbiology; Periodontal Attachment Loss - therapy; Periodontal Pocket - microbiology; Periodontal Pocket - therapy; Placebos; Prevotella intermedia - drug effects; Prevotella intermedia - isolation & purification; Prospective Studies; real-time polymerase chain reaction; root planing; Root Planing - methods; Treatment Outcome; amoxicillin; dental scaling; chronic periodontitis; real-time polymerase chain reaction; diabetes mellitus; metronidazole; root planing
• ISSN: 0303-6979; 1600-051X; 1600-051X
• DOI: 10.1111/jcpe.12282

Aim To evaluate the clinical and microbiological effects of the use of metronidazole (MTZ) + amoxicillin (AMX) as adjuncts to scaling and root planing (SRP) for the treatment of chronic periodontitis (ChP) in type 2 diabetic subjects. Material and Methods Fifty‐eight type 2 diabetic subjects (n = 29/group) with generalized ChP were randomly assigned to receive SRP alone or with MTZ [400 mg/thrice a day (TID)]+AMX (500 mg/TID) for 14 days. Subgingival biofilm samples were analyzed by qPCR for the presence of seven periodontal pathogens. Subjects were monitored at baseline, 3, 6 and 12 months post‐therapies. Results The group receiving SRP+MTZ+AMX presented greater mean probing depth (PD) reduction and clinical attachment gain, a lower number of sites with PD ≥5 mm (primary outcome variable) and a reduced number of subjects with ≥9 of these residual pockets than the control group at 1‐year post‐therapy (p < 0.05). The antibiotic‐treated group also presented reduced levels and greater decreases of the three red complex species, Eubacterium nodatum and Prevotella intermedia, compared to the control group at 1 year (p < 0.05). Conclusions The adjunctive use of MTZ+AMX significantly improved the clinical and microbiological outcomes of SRP in the treatment of type 2 diabetic subjects with ChP.