Shaping the Indications for Periodontal Adjunctive Antibiotics in Dental Practice: A PBRN Clinical Trial
确定牙科实践中牙周辅助抗生素的适应症:PBRN 临床试验
基本信息
- 批准号:10448940
- 负责人:
- 金额:$ 39.13万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-03-11 至 2023-07-31
- 项目状态:已结题
- 来源:
- 关键词:AcademyAdultAdverse eventAffectAmericanAmerican Dental AssociationAmoxicillinAntibiotic ResistanceAntibiotic TherapyAntibioticsBiologicalCalibrationCharacteristicsChronicClassificationClinicalClinical DataClinical Practice GuidelineClinical TrialsCombined AntibioticsComparative StudyConflict (Psychology)DataData CollectionData SetDecision MakingDentalDental ClinicsDental General PracticeDental OfficesDentistryDentistsDentitionDevelopmentDiagnosisDisciplineDiseaseDocumentationEnrollmentEvaluationFeasibility StudiesFocus GroupsGoalsGuidelinesHealthHemorrhageIndividualInflammatoryInvestigationLeadLeftLinkLogistic RegressionsManualsMechanicsMedicalMetronidazoleModelingMonitorMorbidity - disease rateNested Case-Control StudyOral cavityParticipantPatient RecruitmentsPatientsPatternPeriodontal DiseasesPeriodontal InfectionPeriodontitisPersonsPhasePlant RootsPopulationPractice GuidelinesPreparationProceduresProtocols documentationRandomizedRandomized Clinical TrialsReportingResistance developmentSampling StudiesShapesSurveysSystemTooth LossTooth root structureTrainingTranslatingTreatment EffectivenessU-Series Cooperative AgreementsUpdateWorkagedbaseclinical practiceclinically significantdesigneffectiveness evaluationefficacy outcomesevidence baseevidence based guidelinesinstrumentpathogenic bacteriapilot testpilot trialprophylacticrecruitresistant strainresponsesecondary outcometranslational potentialtreatment optimizationtreatment responseyears lived with disability
项目摘要
Shaping the Indications for Periodontal Adjunctive Antibiotics in dental practice: A PBRN Clinical Trial
Periodontitis is a bacterial inflammatory disease that has been reported to affect nearly 40% of Americans
aged 30 years or older. If left untreated, periodontitis can lead to tooth loss and patient-perceived morbidity.
Historically, antibiotic use has been an integral part of periodontal disease treatment. However, antibiotic
stewardship calls for rationalizing their prescription to reduce antibiotic misuse and development of resistant
strains. Across medical disciplines, there is a clear direction to identify individuals who in fact may benefit
from antibiotic use and to provide guidelines for their use. As of 2018, the American Dental Association has
developed evidence-based guidelines limiting circumstances for prophylactic antibiotic use in dental
practice; however, no national guidelines exist for antibiotic use in treatment of periodontal infections
because of lack of adequately powered trials assessing disease- and person-specific indications. Thus,
dentists are left to decide when adjunctive antibiotics are indicated, and which dental patients need them to
achieve periodontal health. In the context of periodontitis treatment, a biological rationale exists to support
adjunctive antibiotic use against periodontal pathogenic bacteria, but clinical results of their use have
presented conflicting results. Currently, very limited documentation of the prescription patterns and utilization
of antibiotics as periodontal treatment adjuncts among US practitioners exist. Nonetheless, data from
academic studies suggest that adjunctive systemic antibiotics may only be beneficial for certain populations,
as the biological response to treatment is highly variable across individuals. This marked variability warrants
the identification of person- and/or disease-related characteristics that are linked to maximum benefit from
adjunctive antibiotic treatment. Consequently, clear guidelines can then be established for tailored
indications for their use with the ultimate goal of minimizing antibiotic misuse in periodontal treatment to
avoid development of antibiotic resistance. The objective of this study is to assess the effectiveness of
adjunctive Amoxicillin/Metronidazole combination antibiotics to non-surgical periodontal therapy in clinical
practices within the National Dental PBRN by conducting the largest randomized clinical trial (RCT) of
adjunctive antibiotics. Further, within this PBRN study, current decision-making factors for adjunctive
antibiotic prescription will be surveyed to assess the state of affairs in clinical practice. Importantly,
leveraging the well-powered RCT dataset, high responders to adjunctive antibiotic treatment will be identified
and the predictive validity of decision-making factors currently employed by clinicians will be assessed to
develop clear indications for prescription. Collectively, results of adjunctive antibiotic use at present are
ambiguous because indications are based on empirical information without evidence-based guidelines,
which may lead to antibiotic misuse and lack of efficacy. The present pragmatic well-powered RCT was
designed to enable the development of evidence-based guidelines for periodontal adjunctive antibiotic use.
塑造牙周辅助抗生素在牙科实践中的适应症:一项PBRN临床试验
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Georgios Kotsakis其他文献
Georgios Kotsakis的其他文献
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{{ truncateString('Georgios Kotsakis', 18)}}的其他基金
Commensal modulation of Peri-implant Microbiome Dysbiosis via Veillonella parvula
小韦荣球菌对种植体周围微生物群失调的共生调节
- 批准号:
10899342 - 财政年份:2023
- 资助金额:
$ 39.13万 - 项目类别:
Shaping the Indications for Periodontal Adjunctive Antibiotics in Dental Practice: A PBRN Clinical Trial
确定牙科实践中牙周辅助抗生素的适应症:PBRN 临床试验
- 批准号:
10841855 - 财政年份:2022
- 资助金额:
$ 39.13万 - 项目类别:
Titanium particle-induced inflammasome activation in the peri-implant mucosal barrier
钛颗粒诱导种植体周围粘膜屏障炎症小体激活
- 批准号:
10360662 - 财政年份:2021
- 资助金额:
$ 39.13万 - 项目类别:
Titanium particle-induced inflammasome activation in the peri-implant mucosal barrier
钛颗粒诱导种植体周围粘膜屏障炎症小体激活
- 批准号:
10218850 - 财政年份:2021
- 资助金额:
$ 39.13万 - 项目类别:
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