Are There Specific Benefits of Amoxicillin Plus Metronidazole in Aggregatibacter actinomycetemcomitans-Associated Periodontitis? Double-Masked, Randomized Clinical Trial of Efficacy and Safety
Are There Specific Benefits of Amoxicillin Plus Metronidazole in Aggregatibacter actinomycetemcomitans-Associated Periodontitis? Double-Masked, Randomized Clinical Trial of Efficacy and Safety
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DOI：
10.1902/jop.2012.120281
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发表时间：
2013-06-01
影响因子：
4.3
通讯作者：
Giannopoulou, Catherine
中科院分区：
文献类型：
--
作者：
Mombelli, Andrea;Cionca, Norbert;Giannopoulou, Catherine
背景：有人建议，在牙周治疗中阿莫西林加甲硝唑的处方应仅限于具有特定微生物特征的患者，特别是那些放线菌聚集杆菌检测呈阳性的患者。本分析的主要目的是确定伴有中度至晚期牙周炎的伴放线菌阳性患者是否特别受益于阿莫西林加甲硝唑作为全口洁牙和根面平整的辅助疗法。方法：这是一项双盲、安慰剂对照、随机纵向研究，包括 41 名伴随放线菌阳性的受试者和 41 名伴放线菌阴性的受试者。 A. 伴放线菌。所有82名患者均在48小时内接受了全口牙周清创术。然后患者接受全身抗生素（375 毫克阿莫西林和 500 毫克甲硝唑，每天 3 次）或安慰剂，持续 7 天。主要结果变量是 3 个月重新评估时探诊深度 (PD) > 4 mm 的部位持续存在以及探诊出血 (BOP)。使用多级逻辑回归，根据以下因素（交互作用）分析抗生素的效果：基线时伴放线菌阳性或阴性、性别、年龄、吸烟、牙齿是否为磨牙以及齿间位置。结果：在重新评估时，测试组参与者的持续 PD > 4 mm 和 BOP 部位明显少于对照患者（P
Background: It has been suggested that prescription of amoxicillin plus metronidazole in the context of periodontal therapy should be limited to patients with specific microbiologic profiles, especially those testing positive for Aggregatibacter actinomycetemcomitans. The main purpose of this analysis is to determine if patients positive for A. actinomycetemcomitans with moderate to advanced periodontitis benefit specifically from amoxicillin plus metronidazole given as an adjunct to full-mouth scaling and root planing.Methods: This is a double-masked, placebo-controlled, randomized longitudinal study including 41 participants who were positive for A. actinomycetemcomitans and 41 participants who were negative for A. actinomycetemcomitans. All 82 patients received full-mouth periodontal debridement performed within 48 hours. Patients then received either systemic antibiotics (375 mg amoxicillin and 500 mg metronidazole, three times daily) or placebo for 7 days. The primary outcome variable was persistence of sites with a probing depth (PD) >4 mm and bleeding on probing (BOP) at the 3-month reevaluation. Using multilevel logistic regression, the effect of the antibiotics was analyzed according to the following factors (interaction effect): A. actinomycetemcomitans-positive or-negative at baseline, sex, age, smoking, tooth being a molar, and interdental location.Results: At reevaluation, participants in the test group had significantly fewer sites with a persisting PD >4 mm and BOP than control patients (P