Effects of topical application of metronidazole-containing mucoadhesive lipogel in periodontal pockets.

INTRODUCTION: Metronidazole is the drug of choice in the treatment of periodontal pockets up to 5 mm in depth. It is topically applied--directly into the periodontal pockets. There are no registred trademark preparations for this purpose in the market of Serbia and Montenegro. The aim of our latest research was to test the efficacy of newly formulated preparation containing 25% metronidazole suspended in a lipogel in vitro--in anaerobic cultures isolated from the periodontal pockets, and in vivo--by the direct application into periodontal pockets. METHODS: Preparation efficacy was tested in a randomized controlled study involving 25 patients, and was confirmed by the membrane-free agar diffusion method on the anaerobic strains isolated from the periodontal pockets. The duration of the testing was 30 days. The preparation was applied twice--immediately after the taking of the first swab, and on day 15, when the control swab was taken for the assessment of the effects of the applied preparation. RESULTS: Seven anaerobic strains were isolated and tested, and each was confirmed as highly susceptible to metronidazole. Anaerobic strains were not isolated in any of the pockets treated with metronidazole-containing lipogel. The strains isolated in the control pockets were the same as were those at the beginning of the study. CONCLUSION: Metronidazole, in a lipogel-type base applied in the concentration of 25%, provided an efficient treatment of anaerobic infection in the periodontal pockets.

[Assessment of feasibility of formulation of a preparation for growth inhibition of metronidazole-resistant strains isolated from periodontal pockets].

INTRODUCTION: Topical metronidazole benzoate preparations, applied directly into the space between the teeth and, periodontal tissue, are the treatment of choice for periodontal pockets. Oleogels and hydrogels, as the biomucoadhesive bases for the manufacturing of these preparations, were developed in our previous trials. The aim of our latest research was to develop a preparation that would solve the problem of inhibiting the metronidazole-resistant anaerobic strains, isolated from the periodontal pockets. METHODS: Metronidazole-resistant strains were isolated from the periodontal pocket swabs, using the established susceptibility testing. Further testing of the antimicrobial activity of the prepared formulations was performed by the membrane-free diffusion method in agar gel. Oleogels and hydrogels were tested with: tetracycline (2.5%), metronidazole (25%), and metronidazole benzoate (40%), as well as with oleogels and hydrogels containing the combination of 2.5% tetracycline and 40% metronidazole benzoate. RESULTS: Satisfying results were achieved with the preparation containing 2.5% tetracycline along with metronidazole benzoate. The main fact revealed by this study was that there was no synergism in tetracycline and metronidazole benzoate activities, if the strain was susceptible to both active substances. CONCLUSION: The best results in the inhibition of the growth of metronidazole-resistant anaerobic strains were obtained by 2.5% tetracycline and metronidazole benzoate preparations in oleogel base.