Metronidazole and amoxicillin for patients with periodontitis and diabetes mellitus: 5-year secondary analysis of a randomized controlled trial

J Periodontol. 2021 Apr;92(4):479-487. doi: 10.1002/JPER.20-0196. Epub 2020 Oct 6.

Abstract

Background: The aim of this study was to perform a 5-year follow-up analysis of a previously-published randomized trial (RCT) evaluating the 2-years effects of metronidazole (MTZ) plus amoxicillin (AMX) as adjuncts to scaling and root planing (SRP) in the treatment of periodontitis in type 2 diabetic patients.

Methods: Volunteers who received periodontal treatment in the aforementioned RCT were selected for clinical and microbiological evaluation. Patients did not receive regular supportive periodontal therapy (SPT) from 2 to 5 years post-treatment.

Results: Of the patients enrolled in the RCT, 43% entered this study (n = 10/control and 15/test group). Most of clinical parameter values, including the number of sites with probing depth ≥ 5 mm (primary outcome variable), were reduced at 5 years post-therapy when compared with baseline in the antibiotic-treated group (P < 0.05), but presented higher values than those at 2 years (P < 0.05). The mean proportions of microbial complexes did not differ between MTZ+AMX+SRP and SRP-only groups at 5 years post-treatment (P > 0.05).

Conclusion: Diabetic patients treated with adjunctive MTZ+AMX were better maintained over a period of 5 years than those treated with SRP only. However, the clinical and microbiological benefits obtained up to 2 years post-treatment were not fully sustained in these patients who did not receive SPT between 2 and 5 years post-treatment.

Keywords: diabetes mellitus; microbiology; periodontitis.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amoxicillin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Dental Scaling
  • Diabetes Mellitus*
  • Humans
  • Metronidazole / therapeutic use
  • Periodontitis* / drug therapy
  • Root Planing
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Metronidazole
  • Amoxicillin