Periodontics

Comparable Effectiveness: Azithromycin vs. Amoxicillin/Metronidazole in Periodontitis

Research Indicates Similar Efficacy Between Azithromycin and Amoxicillin/Metronidazole in Periodontitis Treatment In a recent systematic review and meta-analysi

Dr. Zainab Rangwala

Dr. Zainab Rangwala

Chief Dentist · GDCHJ

3 min read122,968 views
  • systemic antibiotics
  • adverse events
  • azithromycin
  • amoxicillin
  • metronidazole
  • periodontitis
  • clinical outcomes
  • antibiotics
  • antibiotic stewardship
  • Periodontics

Research Indicates Similar Efficacy Between Azithromycin and Amoxicillin/Metronidazole in Periodontitis Treatment

In a recent systematic review and meta-analysis, researchers explored the clinical efficacy and safety of two common antibiotic regimens—systemic azithromycin (AZT) and amoxicillin/metronidazole (AMX/MTZ)—as adjuncts to subgingival instrumentation (SI) for the treatment of periodontitis. The study aimed to ascertain whether one antibiotic regimen displayed superior results over the other in terms of clinical outcomes and safety. The research team conducted a thorough search of electronic databases to identify relevant randomized controlled trials (RCTs), controlled clinical trials, and both prospective and retrospective human studies. Eligibility criteria focused on participants with periodontitis, interventions involving SI with adjunctive systemic AZT or AMX/MTZ, and primary outcomes centered on changes in probing pocket depths.

Results:

The meta-analysis included five studies with a total of 151 participants with periodontitis. Of these, 74 received adjunctive AZT, while the remaining participants received AMX/MTZ as an adjunct to SI. The study found that both AZT and AMX/MTZ had comparable changes in probing pocket depths at 1–3 months, with no statistically significant difference. Interestingly, the adjunctive use of AZT led to significantly fewer residual sites with probing pocket depths of ≥5 mm at 1–3 months compared to AMX/MTZ. Additionally, adverse events were less prevalent among participants who received AZT (9.80%) compared to AMX/MTZ (14.8%), although the meta-analysis did not find a statistically significant difference in the rates of adverse events between the two groups.

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References

  1. [1]European Federation of Periodontology. S3-Level Clinical Practice Guidelines for Periodontology EFP Clinical Guidelines. 2020. Available at: source
  2. [2]Sanz M, Herrera D, Kebschull M, et al.. Treatment of stage I-III periodontitis: The EFP S3 level clinical practice guideline Journal of Clinical Periodontology. 2020. Available at: source

Written by

Dr. Zainab Rangwala

Dr. Zainab Rangwala

Chief Dentist · GDCHJ

With over 12 years of clinical experience, Dr. Zainab Rangwala brings a unique blend of clinical expertise and communication excellence to her role as the Media and PR Head at DentalReach. Passionate about bridging the gap between dentistry and digital communication, she plays a key role in shaping the platform’s voice and outreach.

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