Clarithromycin, as an adjunct to non surgical periodontal therapy for chronic periodontitis: A double blinded, placebo controlled, randomized clinical trial

Objective: Along with conventional non-surgical periodontal therapy (NSPT) systemic anti-microbials may provide more effective treatment for chronic periodontitis by targeting tissue-invasive bacteria. The aim of this randomized, placebo-controlled, double-masked clinical trial was to evaluate the adjunctive effects of oral clarithromycin (CLM) to non-surgical periodontal therapy for chronic periodontitis. Methods: 40 patients were categorized into two groups: test group - scaling and root planing (SRP) plus CLM (500 mg bid, for 3 days) and control group - SRP plus placebo. Clinical parameters were recorded at baseline and at 1, 3, 6, and 9 months. They included gingival index (GI), probing depth (PD), and clinical attachment level (CAL). Also microbial analysis of dental plaque was done at baseline, 3 and 9 months to estimate the levels of periodontopathic organisms using polymerase chain reaction. ANOVA, Chi-square and Bonferroni tests were used for statistical analysis. Results: Thirty-seven subjects completed the study and the results demonstrated that both groups displayed clinical improvements. Using a subject-based analysis, patients treated with SRP + CLM showed enhanced reductions in PD and gains in CAL (p < 0.001) over time, as compared to control group. Also significant reductions in periodontopathic organisms were noticed in the test group compared to control group. However, no statistically significant differences were noted for Tannerella forsythia levels between the groups during the course of the study. Conclusions: The utilisation of CLM in combination with SRP improves the efficacy of NSPT in reducing PD, improving CAL and in lessening microbial loads. Hence, CLM may be beneficial in the non-surgical treatment regimen of chronic periodontitis. (C) 2011 Elsevier Ltd. All rights reserved.