SHORT-TERM SEQUENTIAL ADMINISTRATION OF AMOXICILLIN CLAVULANATE POTASSIUM AND DOXYCYCLINE IN THE TREATMENT OF RECURRENT PROGRESSIVE PERIODONTITIS

THE SYSTEMIC USE OF A SINGLE antibiotic was compared to that of a sequ ential antibiotic regimen in the treatment of A. actinomycetemcomitans and/or P. gingivalis-associated periodontitis. Eleven patients with r ecurrent/progressive periodontitis and demonstrating subgingival infec tion with A.a. and/or P.g. were selected. Six patients received oral a dministration of doxycycline (Do), 200 mg the first day and 100 mg for 4 days thereafter, and then amoxicillin/clavulanate potassium (Au), 5 00 mg 3 times daily for 5 days. The other 5 patients received only dox ycycline for 10 days. Eight sites with greater-than-or-equal-to 5 mm p robe depth per patient were selected, of which 4 received root planing at time 0. Clinical measurements (GI and PI, probing pocket depth, pr obing attachment level, and bleeding upon probing/suppuration) and mic robial infection levels (2 sites/patient as per DNA probe) for A.a. an d P.g. were recorded at 0, 4, 12, and 25 weeks. Clinical data were sub jected to statistical analysis of variance and t-tests for significanc e. The Do + Au groups produced significant reduction in probing pocket depth (PPD) at 4, 12, and 25 weeks (1.1, 1.3, and 1.1 mm, respectivel y). The Do group produced significant reduction in PPD only at 4 and 1 2 weeks (0.8 and 0.8 mm); the Do + Au group produced significant gain of 0.8 mm in probing attachment level at 4 and 12 weeks; and the Do Au group in conjunction with root planing produced the most sustained reduction in PPD and gain in PAL. These findings suggest that the sequ ential use of multiple antibiotic agents may offer greater promise as an adjunctive treatment approach for the management of recurrent and/o r progressive periodontitis than a single antibiotic regimen.