While the adjunctive use of systemic antibiotics alongside non-surgical periodontal therapy is known to improve clinical outcomes, its routine use is not recommended because of their side-effects and the development of antimicrobial resistance.
In this context, German researchers carried out an eight-year retrospective surveillance study on microbiological data of 7,804 patients diagnosed with advanced periodontitis.
The research, now summarised as JCP Digest 93, found that in terms of antibiotic susceptibility, isolates from 63.5% of patients were not susceptible to at least one of the eight antibiotics tested.
A. actinomycetemcomitans showed resistance to metronidazole but not to the other antibiotics, while P. gingivalis and T. forsythia showed a low resistance to amoxicillin.
A trend of decreasing susceptibility of periodontal pathogens to antibiotics was observed over the years. However, susceptibility to amoxicillin and metronidazole – the combination most often used to treat periodontitis – remained unaffected.
Researchers said that the trend of decreasing susceptibility of periodontal pathogens to antibiotics revealed in this study “calls for an evaluation of the efficacy of adjunctive antibiotics regimens in periodontal therapy and the need for further prospective research on antibiotic resistance of periodontal pathogens in relation to clinical outcomes.”
The research was summarised for JCP Digest by postgraduate students of the EFP-affiliated programme in periodontology at the University of Hong Kong.