Amoxicillin safe while breastfeeding

also showed that participants who received A+M after full mouth periodontal debridement had significantly fewer sites with a persisting PD >4 mm and BOP than control patients at three months.

17 This was true for both Aa ?positive as well as Aa ?negative patients. A+M at initial phase also reduced the need for additional surgical treatment.

18 Similar results were also shown in other trials.

49, 68 For aggressive periodontitis, 74% of pockets with PPD ?5 mm at baseline were 4 mm or shallower at six months in the A+M group compared to 54% in the placebo group.

28 To our knowledge, no trials looked at the effect of Az in reducing the number of deep sites.

The studies instead, mainly looked at mean reductions of PPD and/or gain in CAL.

At three months, there was no difference in the mean number of shallow, moderate and deep sites between the groups (ANOVA test).

However, an additional comparative test was carried out to compare the change in the mean number of sites for each PPD category (number of sites at baseline minus number of sites at

review

Despite the absence of statistically significant difference between the groups at baseline, clinically, considerable differences were observed.

The Az group had a greater number of shallow sites compared to other two treatment groups at baseline.

The Az group also had less number of sites with 4–6mm PPD compared to the SRP and the A+M groups at baseline. This difference at baseline could influence the resultant number of sites at three months.

For this reason, comparing the magnitude of change in number of sites (shallow, moderate and deep) that was produced by each medication was a more reliable method to detect a difference (if any) between the treatment groups rather than just looking at mean numbers of sites at three months.

In other words: Was there a difference in the magnitude of increase of shallow sites between the treatment groups?

Was there a

difference

This analysis was done using amoxicillin 875 mg pink the Tukey's post hoc comparison test. It shows that the A+M group has produced a greater increase in the number of shallow pockets (1–3 mm) than the Az group.

At three months, the mean number of shallow sites increased by 21.0 sites in the Az group and 41.9 sites in the A+M group. This difference between the Az and A+M groups was significant ( p ?value = 0.05). These results may suggest that A+M has a better effect than Az in shifting the moderate and deep sites to the shallow category.

As for the moderate and deep sites, no significant difference was noted between the treatment groups.

The figure shows that although the baseline numbers indicate the A+M group had less shallow sites than the Az, at the three months, the number of shallow sites in the A+M increased significantly to ‘catch up’ with the Az group.

A similar trend but in reverse is also seen in the 4–6 mm and the >6 mm category. The graph shows that the reduction in mean number of moderate and deep sites is more evident in the A+M group (but not statistically significant). A larger sample size with a larger number of moderate and deep sites could have depicted a significant difference between the groups. It is also not possible to compare this analysis with previous studies as it amoxicillin prescribing information has not been executed before. Ideally, 19 subjects per group (a total of 57 patients) would have provided 80% power of the study.

This may explain the lack of significant differences that was noted between groups in some of the investigated treatment outcomes. Therefore, the results of this study should be interpreted with caution.

Further studies with a larger sample size could provide more definite conclusions. Being a three?month trial, no conclusions can be drawn from the data presented here with regard to long?term stability.

It has been shown in a long?term study by Goodson et al . that the effects of adjunctive therapy to SRP were minimal at three months and more pronounced. 25 The clinical improvement may continue to occur 3–9 months after the first SRP and long?term stability can be maintained for many years with regular SPT and good patient compliance.

61, 69, 70 The level of compliance of the medication intake was based on a checklist provided to the patients. Only subjects who have complied with the regimen were included in the follow?up analysis.

However, it is not possible to verify if the patients were compliant to the regimens.

The examinations were conducted with a manual probe from which inaccuracies may arise. The probing pressure and angulation of the probe may introduce variability in the results. It is important to note that most amoxicillin 10 days of the above mentioned studies (including the current trial) did not use the microbial composition of the subgingival plaque as a selection criterion for antibiotic therapy. It has been recommended that the use of antibiotics should be based on microbial analysis.

32, 72 This will provide a more targeted approach towards specific pathogens.

Adjunctive antibiotics may be of minimal clinical benefit in the absence of Aa 26 and Pg 73 in periodontitis patients.

Microbial diagnostics prior to AB prescription can also minimize the risk for antimicrobial resistance, which is becoming a global emerging challenge in the control of infectious diseases. Within the limitations of the study, it can be concluded that adjunctive systemic antibiotics used during the initial phase of treatment (in conjunction with thorough mechanical debridement) may have an additional benefit in the clinical outcomes.

A+M showed a higher reduction in PPDs compared to Az in the ‘all sites analysis’.

In molars, the reduction in BOP and PPD was more in the A+M than the SRP. Gain of CAL in molar sites was only detected in the two antibiotic groups but not in the SRP group. The pocket depth of the 4–6 mm category also reduced more in the A+M than the SRP. Finally, A+M showed a higher increase in the number of sites with PPD 1–3 mm than Az at three months.

A replication of the study with the ideal sample size may help confirm the current results and perhaps provide additional conclusions. This study was supported by a grant from the Australian Periodontology amoxicillin & clavulanic acid Research Foundation (APRF). A special thanks to Mr Martin Firth for conducting the statistical analyses.

The medications involved were supplied by Fremantle Pharmacy (39 Adelaide Street, Fremantle, Western Australia) and were purchased at no discounted rates. The authors declare that there are no conflicts of interest in this study. Comparing 3 versus 7 days systemic administration of Amoxicillin (AMX) and Metronidazole (MET) in severe chronic periodontitis patients. Background and study aims Chronic

periodontitis

University of Medicine and Pharmacy "IUliu Hatieganu" Cluj Napoca (Romania) Who is amoxicillin 300 mg the main contact? The ideal time of systemic metronidazole and amoxicillin administration in the treatment of severe periodontitis: study protocol for a randomized controlled trial. Trials volume 19 , Article number: 201 ( 2018 ) Cite this article.

The combination of systemic metronidazole (MTZ) and amoxicillin (AMX) with scaling and root planing (SRP) has shown to be an effective periodontal treatment. However, some essential issues associated with the use of these antibiotics remain unanswered, such as the ideal time of administration during the course of periodontal treatment. Although these agents are often prescribed after the healing phase of the SRP procedure, there is biological plausibility to support its use in conjunction with the mechanical treatment.

However, to date, no placebo controlled randomized clinical trial (RCT) has directly compared these two protocols.

Therefore, the aim of this RCT is to compare the clinical, microbiological and immunological effects of the adjunctive systemic MTZ + AMX administered in different phases of the treatment of severe periodontitis.

Subjects with severe periodontitis ( n = 180) are being randomly assigned into three groups ( n = 60/group): (i) SRP-only (control group), SRP in combination with 400 mg MTZ + 500 mg AMX, starting (ii) at the first SRP session (active phase group), or (iii) after 3 months of its completion (healing phase group). All volunteers are receiving clinical and microbiological evaluation at baseline, 3, 6 and 12 months, and immunological assessment at baseline and 12 months post-therapy.

Nine subgingival biofilm samples are being collected per subject and analyzed for counts and proportions of 40 bacterial species by checkerboard DNA-DNA hybridization, and six gingival crevicular fluid samples are being collected and analyzed for the levels of 20 chemokines by multiplex immunoassay. The primary outcome variable is the number of volunteers reaching the clinical endpoint for treatment (? 4 sites with probing depth ?5 mm) at 1 year post-therapy.