Administration of systemic antibiotics during non-surgical periodontal therapy—a consensus report

Abstract

Aim

The aim of this meta-review was to evaluate whether there is a meaningful clinical benefit regarding the use of systemic adjunctive antibiotics in the treatment of patients with periodontitis. Additionally, a consensus regarding possible recommendations for future administration of antibiotics should be reached.

Methods

A structured literature search was performed by two independent investigators focusing on systematic reviews (SR) covering adjunctive systemic antibiosis during non-surgical periodontal therapy. Additionally, recent randomized clinical trials (RCT, July 2015 to July 2017) were searched systematically to update the latest SR. Results were summarized and discussed in a plenary to reach a consensus.

Results

Mostly, systematic reviews and RCTs showed a significant positive effect of adjunctive systematic antibiosis compared to controls. These positive effects gain clinical relevance in patients with severe periodontal disease aged 55 years and younger.

Conclusion

Systemic antibiotics as an adjunct to non-surgical periodontal therapy should be sensibly administered and restrictively used. Only certain groups of periodontitis patients show a significant and clinically relevant benefit after intake of systemic antibiosis during periodontal therapy.

Clinical relevance

Avoiding antibiotic resistance and possible side effects on the human microbiome should be a focus of dentists and physicians. Thus, a sensible administration of antibiotics is mandatory. This manuscript suggests guidelines for a reasonable use.

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Acknowledgements

The authors thank Dr. Samir Abou-Ayash (DGI), Prof. Dr. Ralf Bürgers (DG PRO), Dr. Thomas Eger (AKPP), Prof. Dr. Stefan Frantz (DGK), Dr. Dr. Ralf Kettner (DGMKG), Dr. Stefan Liepe (BDIZ EDI), Priv.-Doz. Dr. Annette Moter (DGHM), Prof. Dr. Rainer Müller (DG HNO-KHC), Dr. Silke Riemer (BZÖG), Prof. Dr. Stefan Rupf (DGZ), Marion Schellmann (VMF Referat Zahnmedizinische Fachangestellte), Frau Tugce Schmitt (KZBV), and Priv.-Doz. Dr. Dirk Ziebolz, M.Sc. (DGZ).

Funding

This study was partially funded by a grant of the DG PARO and AWMF research fund, and for Yvonne Jockel-Schneider, a grant of the Commission for Young Scientists and Gender Equality, University of Wuerzburg (2.2-220.522-97/15_1) and the IZKF (2.2-220.522-97/2015_1).

The consensus conference was planned, organized, and financed by DG PARO®. In addition, the consensus task force of the German Society for Dental and Oral Medicine (DGZMK), Federal Dental Association (BZÄK), and German corporation of public dentists (KZBV) contributed to the financing. Thus, the consensus paper could be established in editorial independence.

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Pretzl, B., Sälzer, S., Ehmke, B. et al. Administration of systemic antibiotics during non-surgical periodontal therapy—a consensus report. Clin Oral Invest 23, 3073–3085 (2019). https://doi.org/10.1007/s00784-018-2727-0

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Keywords

  • Periodontal therapy
  • Antibiotic
  • Adjunctive systemic antibiosis
  • Non-surgical therapy