LAUSR

BACKGROUND To assess the clinical and microbiological responses of amoxicillin + metronidazole (AMX + MET) versus clarithromycin (CLM) as adjuncts to one-stage full-mouth ultrasonic debridement (FMUD) in the treatment of generalized aggressive periodontitis (GAgP). MATERIALS For this parallel, double-blind, pilot randomized clinical trial, 46 patients with GAgP were selected and randomly assigned into two groups: AMX+MET group (n = 23): FMUD associated with amoxicillin (500 mg tid) and metronidazole (400 mg tid) for 7 days; and CLM group (n = 23): FMUD associated with CLM (500 mg bid) for 7 days. Clinical parameters were evaluated at baseline, 3 and 6 months post-treatment. The levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Fusobacterium nucleatum from subgingival biofilm were determined by quantitative polymerase chain reaction. RESULTS Both treatments significantly improved all clinical parameters compared to baseline and promoted a significant reduction of A. actinomycetemcomitans and P. gingivalis counts (p > 0.05). CLM succeeded in decreasing T. forsythia at 6 months (p < 0.05), but no antibiotic was able to reduce F. nucleatum. There was no difference between the two protocols regarding the reported adverse effects (p > 0.05). CONCLUSION The results suggest that CLM is not superior than AMX+MET in the treatment of GAgP. However, this antibiotic led to good clinical outcomes and may be a possible alternative to AMX+MET in the treatment of severe periodontitis in young patients. Future studies with larger sample sizes are needed to confirm this statement (NCT02969928). This article is protected by copyright. All rights reserved.