JADA+ ContentJADA+ Clinical ScansUsing amoxicillin plus metronidazole as an adjunct to nonsurgical periodontal treatment results in little benefit, and there seems to be no difference among regimens
Section snippets
Key words
Periodontology; adjuvant treatment; antibiotics; periodontitis; optimal regimen; systematic review.
Clinical relevance
Many periodontists use systemic antibiotics as an adjuvant to periodontal treatment to improve outcomes. Knowing what regimen achieves the best outcomes may help clinicians to make treatment decisions.
Study summary
The authors conducted a systematic review (SR) to determine the optimal dose and duration of amoxicillin plus metronidazole (AM) as adjunct to nonsurgical periodontal therapy (NSPT). They searched 2 electronic databases through April 2017 for randomized clinical trials (RCTs) comparing AM with a placebo in participants receiving NSPT. They conducted analyses to determine whether the effects of specific doses and duration of AM were different from those of other doses and durations.∗
Strengths and limitations
This SR suggests that there may be no differences 3 months after treatment in the effects of different doses and duration of AM used as an adjunct to NSPT. The ideal type of study design to answer this question is an RCT that compares 1 regimen of AM directly with another. We do not know why the authors chose to perform indirect comparisons between different doses and durations of AM regimens using a placebo as a common comparator. Although this may be an acceptable option when the ideal type
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Disclosure. Dr. Brignardello-Petersen did not report any disclosures.
This review does not in any way substitute for professional advice and should not be regarded as clinical guidance. As always, any evidence should be carefully considered by clinician and patient to ensure that in their views, all potentially desirable consequences outweigh all potentially undesirable consequences.