Comparación de efectividad de amoxicilina/metronidazol y de azitromicina como terapia coadyuvante durante el tratamiento periodontal no quirúrgico en pacientes con periodontitis crónica severa generalizada. Revisión sistemática

Abstract

Objective: To establish whether amoxicillin plus metronidazole is more effective than azithromycin as adjunctive therapy during non-surgical periodontal treatment (NSPT) in patients diagnosed with generalized severe chronic periodontitis. Methodology: Systematic review of the literature according to the PRISMA protocol using the PubMed and Scielo databases. Clinical trials that have used amoxicillin with metronidazole, azithromycin or both as an adjuvant to NSPT, published in the last 10 years were included. The variables probing depth reduction (PD), bleeding on probing reduction (BOP) and clinical attachment level reduction (CAL) were used. Results: A total of 184 articles were reviewed, of which 7 met the eligibility criteria and were included in the review. Three of these used amoxicillin with metronidazole, one obtained azithromycin, and three used both antibiotics in their study groups. Conclusions: Both antibiotic regimens used in clinical trials (azithromycin and amoxicillin with metronidazole) as adjuvants to NSPT in patients with generalized chronic periodontitis, achieve better results in the clinical parameters of PD, CAL and BOP when compared to NSPT without use of antimicrobials The antibiotic therapy of amoxicillin with metronidazole, used in NSPT, achieves significantly better results than azithromycin according to clinical parameters of PD, BOP and CAL. It is suggested that future studies implement other antibiotic schemes to determine more effective alternatives as adjuvants in NSPT.