Clinical Studies of Systemic Antibiotic Therapy in Patients With Severe Periodontitis

Reference N Patients / Test Control Follow-up Outcomes

Disease Time
(months)
Metronidazole

Loesche et al. 15 test; 18 Scaling + MET Placebo 1-1.5 Test showed more reduction in
(1992) Placebo / PPA 250 mg t.i.d., 7 medication PD, more gain in CAL, reduced
days level of pathogens, and less
need for surgery

Saxén & 27/LAgP Scaling + MET Scaling 18 Best clinical results with MET. Aa
Asikainen 200 mg t.i.d., 10 eliminated in 100% of MET
(1993) days or TET 250 group, in 44% of TET group, and
mg q.i.d., 12 in 67% of scaling group
days
Nieminen et al. 18 test; 15 Scaling + MET Modified 18 Test showed less BOP and more
(1996) control / PPA 250 mg t.i.d., 10 Widman flap reduction in PD
days surgery
Palmer et al. 31 test; 27 Ultrasonic Ultrasonic 6 Test and control group showed
(1998) control / PPA scaling + MET scaling no statistically significant
200 mg t.i.d. for differences
7 days
Soder et al. 32 test; 32 Scaling/surgery Placebo 60 PD significantly reduced in test
(1999) placebo or no surgery + medication but not in placebo group
MET 400 mg
t.i.d, 7 days
 Clinical Studies of Systemic Antibiotic Therapy in Patients With Severe Periodontitis

Reference N Patients / Test Control Follow-up Outcomes

Disease Time
(months)
Clindamycin
Gordon et al. 13/PPA Scaling + CLIN None 12 CLIN + scaling improved clinical
(1990) 150 mg q.i.d., 7 d variables, reduced motile
organisms, and decreased
annual rate of sites with disease
activity from 1.0% to 0.5%

Walker & 24/LAgP Scaling + CLIN None 12 CLIN + scaling improved clinical
Gordon (1990) 150 mg q.i.d., 7 d variables and reduced annual
rate of sites with disease activity
from 8.0% to 0.5%. Pg, Pi, and
Pm were reduced or absent from
12 months
Penicillins / Amoxicillin
Kunihira et al. 16/LAgP Surgery + Placebo 9 No advantage to adjunctive PEN
(1985) PEN 250 mg medication
q.i.d., 10 d every
3 month for 9
months
Haffajee et al. 40/PPA Surgery + Placebo 10 AMOX/CLA improved PD
(1995) AMOX/CLA, 250 medication and CAL compared to
mg t.i.d., 30 days Placebo. More decrease in Aa, Pg,
Pi, and Cr with AMOX/CLA than
with placebo
 Clinical Studies of Systemic Antibiotic Therapy in Patients With Severe Periodontitis

Reference N Patients / Test Control Follow-up Outcomes

Disease Time
(months)

Tetracycline/Doxycycline

Rams & 21/PPA TET 250 mg Placebo 11 TET reduced PD, motile
Keyes (1983) q.i.d., 14 d medication organisms, and crevicular
leukocytes recalcitrant sites;

Novak et al. 4/LAgP TET 250 mg None 2-48 TET without scaling reduced
(1988) q.i.d., 42 d PD, CAL, and BOP for up to
4 years
Saxen et al. 7 test; Scaling + DOX Placebo 20 DOX reduced Aa better than
(1990) 7control / 100 mg q.d., medication placebo; double-blind study
LAgP 13d

Haffajee et al. 40/PPA Surgery +TET Placebo 10 TET improved PD and CAL
(1995) 250mg q.i.d., medication compared to placebo or
30 d ibuprofen. More decrease in
Aa, Pg, Pi and Cr with TET
than with placebo
 Clinical Studies of Systemic Antibiotic Therapy in Patients With Severe Periodontitis

Reference N Patients / Test Control Follow-up Outcomes

Disease Time
(months)

Combination therapy

van 22/LAP; Scaling + MET None 3-9 Improved clinical status. Aa

Winkelhoff et 90/PPA 250mg + was eliminated in 97% and
al. (1992) AMOX 375 mg Pg in 88% of patients.
t.i.d., 7 d

Berglundh et 8 test; 8 Scaling + MET Placebo 12-24 Improved clinical status. Aa

al. (1998) control / 250mg + and Pg were markedly
PPA AMOX 375 mg suppressed or eliminated 2
t.i.d., 14 d months postoperatively
Flemmig et al. 18 test; 20 Scaling + MET scaling 12 Patients harboring Aa and
(1998) control / 250mg + Pg benefited clinically and
PPA AMOX 375 mg microbiologically from the
t.i.d., 8 d antibiotic therapy
Winkel et al. 23 test; 26 Scaling + MET Placebo 6 More improvement in PD,
(2001) control / 250mg + Cal and BOP and more
PPA AMOX 375 mg suppression of Pg, Tf and Pi
t.i.d., 7 d in the antibiotic group than
in placebo group