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Eickholz, Peter; Koch, Raphael; Göde, Moritz; Nickles, Katrin; Kocher, Thomas; Lorenz, Katrin; Kim, Ti‐Sun; Meyle, Jörg; Kaner, Doğan; Schlagenhauf, Ulrich; Harks, Inga; Ehmke, Benjamin

Clinical benefits of systemic amoxicillin/metronidazole may depend on periodontitis stage and grade: An exploratory sub‐analysis of the ABPARO trial

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  • Media type: E-Article
  • Title: Clinical benefits of systemic amoxicillin/metronidazole may depend on periodontitis stage and grade: An exploratory sub‐analysis of the ABPARO trial
  • Contributor: Eickholz, Peter; Koch, Raphael; Göde, Moritz; Nickles, Katrin; Kocher, Thomas; Lorenz, Katrin; Kim, Ti‐Sun; Meyle, Jörg; Kaner, Doğan; Schlagenhauf, Ulrich; Harks, Inga; Ehmke, Benjamin
  • imprint: Wiley, 2023
  • Published in: Journal of Clinical Periodontology
  • Language: English
  • DOI: 10.1111/jcpe.13838
  • ISSN: 0303-6979; 1600-051X
  • Keywords: Periodontics
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:sec><jats:title>Aim</jats:title><jats:p>Assessment of treatment response after systemic amoxicillin/metronidazole adjunctive to subgingival instrumentation (SI) according to stages and grades of the 2018 classification of periodontal diseases.</jats:p></jats:sec><jats:sec><jats:title>Materials and Methods</jats:title><jats:p>We carried out exploratory re‐analysis of the placebo‐controlled, multi‐centre ABPARO trial (52; 45/60 years of age; 205 males, 114 active smokers). Patients were randomized to SI with systemic amoxicillin 500 mg/metronidazole 400 mg (three times a day for 7 days, <jats:italic>n</jats:italic> = 205; ANTI) or placebo (<jats:italic>n</jats:italic> = 200; PLAC) and maintenance therapy every 3 months. Patients were reclassified according to the 2018 classification (stage/extent/grade). Treatment effect was the percentage of sites per patient with new attachment loss ≥1.3 mm (PSAL ≥ 1.3 mm) at 27.5 months post‐baseline/randomization.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>All patients were assigned according to the stage (<jats:italic>n</jats:italic> = 49 localized stage III, <jats:italic>n</jats:italic> = 206 generalized stage III, <jats:italic>n</jats:italic> = 150 stage IV). Because of missing radiographs, only 222 patients were assigned to grades (<jats:italic>n</jats:italic> = 73 B, <jats:italic>n</jats:italic> = 149 C). Treatment (PLAC/ANTI) resulted in PSAL ≥ 1.3 mm (median; lower/upper quartile) in localized stage III (PLAC: 5.7; 3.3/8.4% vs. ANTI: 4.9; 3.0/8.3%; <jats:italic>p</jats:italic> = .749), generalized stage III (8.0; 4.5/14.3% vs. 4.7; 2.4/9.0%; <jats:italic>p</jats:italic> &lt; .001), stage IV (8.5; 5.1/14.4% vs. 5.7; 3.3/10.6%; <jats:italic>p</jats:italic> = .008), grade B (4.4; 2.4/6.7% vs. 3.6; 1.9/4.7%; <jats:italic>p</jats:italic> = .151) and grade C (9.4; 5.3/14.3% vs. 4.8; 2.5/9.4%; <jats:italic>p</jats:italic> &lt; .001).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>In generalized periodontitis stage III/grade C, a clinically relevant lower percentage of disease progression after adjunctive systemic amoxicillin/metronidazole was observed compared to placebo (PLAC: 9.7; 5.8/14.3% vs. ANTI: 4.7; 2.4/9.0%; <jats:italic>p</jats:italic> &lt; .001).</jats:p></jats:sec>