Amoxicillin Plus Metronidazole Therapy for Patients with Periodontitis and Type 2 Diabetes: A 2-year Randomized Controlled Trial

Author(s)

Tamashiro, N. S. ^[1] ; Duarte, P. M. ^[1] ; Miranda, T. S. ^[1] ; Maciel, S. S. ^[1] ; Figueiredo, L. C. ^[1] ; Faveri, M. ^[1] ; Feres, M. ^[1]

Affiliation

^[1] Univ Guarulhos, Dent Res Div, Dept Periodontol, Sao Paulo - Brazil

• Document type: Journal article
• Source: JOURNAL OF DENTAL RESEARCH; v. 95, n. 7, p. 829-836, JUL 2016.
• Web of Science Citations: 7

Abstract

The aim of this study was to assess the changes occurring in subgingival biofilm composition and in the periodontal clinical parameters of subjects with periodontitis and type 2 diabetes mellitus (DM) treated by means of scaling and root planing (SRP) only or combined with systemic metronidazole (MTZ) and amoxicillin (AMX). Fifty-eight subjects were randomly assigned to receive SRP only (n = 29) or with MTZ (400 mg/thrice a day {[}TID]) and AMX (500 mg/TID) (n = 29) for 14 d. Six subgingival plaque samples/subject were analyzed by checkerboard DNA-DNA hybridization for 40 bacterial species at baseline and 3 mo, 1 y, and 2 y posttherapy. At 2 y posttherapy, the antibiotic-treated group harbored lower mean proportions (5.5%) of red complex pathogens than the control group (12.1%) (P < 0.05). The proportions of the Actinomyces species remained stable in the antibiotic group but showed a statistically significant reduction in the control group from 1 to 2 y in subjects achieving a low risk clinical profile for future disease progression (i.e., = 4 sites with probing depth {[}PD] <= 5 mm). The test group also had a lower mean number of sites with PD >= 5 mm (3.5 +/- 3.4) and a higher percentage of subjects reaching the low risk clinical profile (76%) than the control group (14.7 +/- 13.1 and 22%, respectively) (P < 0.05) at 2 y posttreatment. MTZ + AMX intake was the only significant predictor of subjects achieving the low risk at 2 y (odds ratio, 20.9; P = 0.0000). In conclusion, the results of this study showed that the adjunctive use of MTZ + AMX improves the microbiological and clinical outcomes of SRP in the treatment of subjects with generalized chronic periodontitis and type 2 DM up to 2 y (ClinicalTrials. gov NCT02135952). (AU)

• FAPESP's process: 11/14872-4 - Systemic metronidazole and amoxicillin as adjuncts to scaling and root planing in the treatment of chronic periodontitis in type 2 diabetic subjects: clinical, glycemic and microbiological evaluations
• Grantee: Tamires Szeremeske de Miranda
• Support Opportunities: Scholarships in Brazil - Master
• FAPESP's process: 13/01072-5 - Systemic metronidazole and amoxicillin as adjuncts to scaling and root planing in the treatment of chronic periodontitis in type 2 diabetic subjects: clinical, glycemic and microbiological evaluations
• Grantee: Poliana Mendes Duarte
• Support Opportunities: Regular Research Grants