zithromax and Periodontal-Diseases

Azithromycin is a macrolide antibiotic used extensively in medicine for the treatment of a wide range of infections such as upper respiratory tract infections, middle ear infections, sexually transmitted infections and trachoma. It is also effective against the most common periodontopathogens. The versatility of the macrolides extends beyond their antibiotic properties as a result of their well-documented immune-modulating/anti-inflammatory effects. Macrolides, including azithromycin, are therefore used to treat diseases not associated with bacteria, such as severe asthma, chronic obstructive pulmonary diseases and, more recently, cystic fibrosis. Azithromycin is concentrated in neutrophils, macrophages and particularly fibroblasts; all of these cells are central players in the pathogenesis of most periodontal diseases. This paper reviews the diverse properties of azithromycin and the clinical periodontal studies of its effects in both the treatment of periodontitis and in resolving drug-related gingival overgrowth. Evidence exists to support the use of a single course of azithromycin in the treatment of advanced periodontal diseases. Azithromycin could have a triple role in the treatment and resolution of periodontal diseases: suppressing periodontopathogens, anti-inflammatory activity and healing through persistence at low levels in macrophages and fibroblasts in periodontal tissues, even after a single course of three tablets. If future periodontal research confirms these properties, it could become a valuable host-modulator in periodontal treatment.

Topics: Anti-Bacterial Agents; Anti-Inflammatory Agents; Azithromycin; Fibroblasts; Gingival Overgrowth; Humans; Immunologic Factors; Macrophages; Periodontal Diseases; Periodontitis

Azithromycin has adequate tissue levels for 7 days with a 3 day treatment regimen. The antibacterial activity is excellent. In dental infections, recurrence of infection happens when antibiotics cause a temporary improvement in symptoms but the etiologic agent is not eradicated. Azithromycin produces a "focused" cure and is an appropriate antibiotic for these infections. For this reason, the antibiotic was approved.

Topics: Anti-Infective Agents; Azithromycin; Bacteria; Bacterial Infections; Clinical Trials as Topic; Double-Blind Method; Drug Resistance, Bacterial; Fluoroquinolones; Humans; Naphthyridines; Periodontal Diseases; Treatment Outcome

Periodontal disease is considered to be a bio?film infectious disease. The effects of macrolide and tetracycline on biofilm were examined in in vitro biofilm model made of periodontal disease-associated bacteria.. Biofilms were made on salivary pellicle by adding Streptococcus gordonii for 2 days, followed by Porphyromonas gingivalis inoculation for 2, 5, or 12 days. Biofilms were treated with macrolide antibiotics; erythromycin (EM), azithromycin (AZM) and josamycin (JOM) and tetracycline antibiotic, minocycline (MINO). The effects of these antibiotics on biofilms were examined using colorimetric quantification method, scanning electron microscope (SEM) and confocal laser scanning microscopy (CLSM).. When antibiotics were added to the biofilm 2 days after inoculation of Porphyromonas gingivalis (biofilm inhibition model), all four antibiotics decreased the number of bacteria by both colorimetric method and SEM observation. When antibiotics were added to biofilms 5 or 12 days after inoculation (biofilm destruction model), those in biofilms were decreased by EM and AZM compared with JOM and MINO. Moreover, CLSM observation demonstrated that EM and AZM killed bacteria in biofilm more deeply than JOM and MINO.. These results suggest the feasibility of EM and AZM for the treatment of periodontal disease as a biofilm infectious disease.

Topics: Anti-Bacterial Agents; Azithromycin; Biofilms; Erythromycin; Humans; In Vitro Techniques; Periodontal Diseases; Porphyromonas gingivalis; Streptococcus gordonii

Topics: Administration, Oral; Anti-Bacterial Agents; Azithromycin; Erythromycin; Humans; Periodontal Diseases