Non-surgical periodontal therapy supplemented with systemically administered azithromycin: a systematic review of RCTs.

BACKGROUND: Azithromycin may be an alternative adjunctive systemic antibiotic in non-surgical periodontal therapy. OBJECTIVE: This study aims to identify randomized controlled trials evaluating non-surgical periodontal treatment of chronic and/or aggressive periodontitis supplemented with systemically administered azithromycin. MATERIALS AND METHODS: A systematic literature search was performed for publications published by 31 March 2014 using electronic databases and hand search. Randomized controlled trials published in English or German language, with a follow-up >/=6 months were included. From 231 titles identified, nine publications were eligible for inclusion. RESULTS: Among the studies included, showing some risk of bias, seven reported on patients with chronic periodontitis and two with aggressive periodontitis. Minor adverse events were described in five studies. A synthesis of results using a vote counting method was applied. Significant (p < 0.05) beneficial effects of azithromycin were shown in six studies for probing depth changes and in five studies for clinical attachment level changes. CONCLUSION: In contrast to aggressive periodontitis patients, data from this analysis indicate a potential benefit of systemic azithromycin as adjunctive to non-surgical periodontal therapy in chronic periodontitis patients. CLINICAL RELEVANCE: When contraindications for the standard antibiotics are present, azithromycin (AZM) may be considered as alternative systemically administered antibiotic drug in selected cases of chronic periodontitis.