Spotlight on systemic antimicrobial adjunctive therapy in aggressive periodontitis

ABSTRACT

In this study, 35 adult patients with untreated aggressive periodontitis were exposed to a microbiological analysis to define the kind of oral microorganisms causing this disease. They were found to harbor sub-gingival Prevotella intermedia, Porphyromonas gingivalis, Capnocytophaga species, Actinobacillus actinomycetemcomitans and Eikenella corrodens as the common putative and anaerobic microorganisms causing the disease. Moreover, a follow up study was carried out on 45 adult patients with untreated aggressive periodontitis. According to the antimicrobial regimens, the patients were treated for 14 days with amoxicillin/clavulanic acid, either alone [group I] or combined with any of certain drugs, including doxycycline 100 mg/day [group II], metronidazole 750 mg/day [group III], doxycycline 100 mg/day and metronidazole 750 mg/day [group IV], doxycycline 20 mg twice daily and metronidazole 750 mg/day [group V]. The study concluded that the systemic administration of the antimicrobial agents as adjunctive therapy of aggressive periodontitis is effective in improving the inflammatory condition. Drug combination therapy is more effective than monotherapy with single agent. The administration of a combination of amoxicillin/clavulanic acid, metronidazole and doxycycline proved an optimum adjunctive drug therapy of periodontitis. The administration of doxycycline in this combination in a sub-antimicrobial dose of 20 mg bid is as effective as doxycycline in a dose of 100 mg/day