Differential effects of systemic metronidazole and amoxicillin on Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in intraoral habitats

J Clin Periodontol. 1998 Jan;25(1):1-10. doi: 10.1111/j.1600-051x.1998.tb02356.x.

Abstract

48 adult patients with untreated periodontitis harboring subgingival Actinobacillus actinomycetemcomitans and/or Porphyromonas gingivalis were randomly assigned to receive full mouth scaling alone (control) or scaling with systemic metronidazole plus amoxicillin and supragingivai irrigation with chlorhexidine digluconate (test). Subgingival plaque and swab samples from tongue, tonsils, and buccal mucosa were taken at baseline, 10 days and 3, 6, 9, and 12 months. A. actinomycetemcomitans was detected in the oral cavity, i.e., subgingival plaque and/or mucous membranes, less frequently in test patients compared to controls at 9 and 12 months (p<0.01), whereas, the intraoral detection frequency of P. gingivalis was significantly reduced only 10 days following therapy (p<0.001). At any time after therapy, A. actinomycetemcomitans was not detected intraorally in 5 of 10 (50%) test and 1 of 13 (8%) control patients harboring this pathogen at baseline; P. gingivalis was not detected in only 1 of 18 (6%) test and none of the 17 control patients harboring this pathogen at baseline. Although the data indicated that the assessed antimicrobial therapy may suppress A. actinomycetemcomitans from the entire oral cavity below detectable levels over a minimum of 12 months, P. gingivalis persisted or reoccurred.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Aggregatibacter actinomycetemcomitans / drug effects*
  • Aggregatibacter actinomycetemcomitans / growth & development
  • Aggregatibacter actinomycetemcomitans / isolation & purification
  • Amoxicillin / administration & dosage
  • Amoxicillin / therapeutic use*
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Anti-Infective Agents, Local / administration & dosage
  • Anti-Infective Agents, Local / therapeutic use
  • Chlorhexidine / administration & dosage
  • Chlorhexidine / analogs & derivatives
  • Chlorhexidine / therapeutic use
  • Colony Count, Microbial
  • Dental Plaque / microbiology
  • Dental Scaling
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Metronidazole / administration & dosage
  • Metronidazole / therapeutic use*
  • Middle Aged
  • Mouth Mucosa / microbiology
  • Mouthwashes
  • Palatine Tonsil / microbiology
  • Penicillins / administration & dosage
  • Penicillins / therapeutic use*
  • Periodontitis / drug therapy
  • Periodontitis / microbiology*
  • Periodontitis / therapy
  • Porphyromonas gingivalis / drug effects*
  • Porphyromonas gingivalis / growth & development
  • Porphyromonas gingivalis / isolation & purification
  • Tablets
  • Therapeutic Irrigation
  • Tongue / microbiology

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local
  • Mouthwashes
  • Penicillins
  • Tablets
  • Metronidazole
  • Amoxicillin
  • chlorhexidine gluconate
  • Chlorhexidine