Some evidence to support adjunctive amoxicillin and metronidazole for treating patients with aggressive periodontitis

Assorted pills

Most people suffer with inflamed gums for time to time. However, approximately 10% of the population suffer from more severe gum problems (periodontitis) leading to loss of bone supporting the teeth and potentially loss of teeth.  The aim of this review was to assess the effectiveness of combined amoxicillin and metronidazole (AMX/MET) as an adjunctive treatment to full-mouth scaling root planing (FMSRP) compared with FMSRP alone in patients with aggressive periodontitis.

The authors searched eight databases and hand-searched ten international dental journals. The main outcome measures were clinical attachment level (CAL), reduction in probing depth (PD) with adverse events and other secondary outcomes being considered. The date were pooled using a random effects model. The weighted mean difference with 95% confidence interval (CI) was calculated for continuous outcomes, while risk difference (RD) with 95% CI was used for dichotomous data; heterogeneity was assessed with the Cochrane χ(2) and I(2) tests. The level of significance was set at p < 0.05.

Six randomized clinical trials were included and they found:-

  • A significant CAL gain (MD: 0.42; 95% CI: 0.23 -0.61; p < 0.05) and PD reduction (MD: 0.58; 95% CI: 0.39-0.77; p < 0.05) in favour of FMSRP + AMX/MET
  • No significant RD was found in the occurrence of adverse events (RD: 0.01; 95% CI: -0.02-0.04, p > 0.05).

The authors concluded:-

The findings of the meta-analysis seem to support the effectiveness and the clinical safety of FMSRP + AMX/MET; however, future studies are needed to confirm these results.

Sgolastra F, Petrucci A, Gatto R, Monaco A. Effectiveness of Systemic Amoxicillin/Metronidazole as an Adjunctive Therapy to Full-Mouth Scaling and Root Planing in the Treatment of Aggressive Periodontitis: A Systematic Review and Meta-Analysis. J Periodontol. 2011 Nov 3. [Epub ahead of print] PubMed PMID:22050545.

Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+
Mark as read
Create a personal elf note about this blog
Profile photo of Derek Richards

Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

More posts - Website

Follow me here –