Fluoroquinolones in the treatment of Actinobacillus actinomycetemcomitans associated periodontitis

Background: Periodontitis patients harboring Actinobacillus actinmycetemcom itans (Aa) are prime candidates for systemic antibiotic therapy. Besides te tracycline and the combination of metronidazole and amoxicillin the fluoroq uinolones are also believed to have antibacterial activity against Aa. The aim of the present study was to evaluate systemic ofloxacin therapy as adju nct to flap surgery. Methods: Twenty-five adult periodontitis patients with subgingival detectio n of Aa were treated with 2x200mg/d ofloxacin for 5 days as adjunct to open flap surgery (test). Another 10 patients received only flap surgery (contr ol). Probing depth (PD) and clinical attachment level (CAL) was recorded an d subgingival plaque samples were cultivated on TSBV agar for detection of Aa at baseline as well as 3 and 12 months following therapy. Results: At 3 and 12 months following therapy mean PD at monitored sites in the test group changed from 6.8 mm (+/-1.3) to 3.6 mm (+/-1.0), 3.8 mm (+/ -1.1) and CAL from 7.5 mm (+/-1.4) to 5.4 mm (+/-1.4), 5.5 mm (+/-1.3). In the control group PD changed from 6.5 mm (+/-0.7) to 4.0 mm (+/-1.7), 4.1 m m (+/-1.6) and CAL from 7.5 mm (+/-1.0) to 6.3 mm (+/-1.7), 6.4 mm (+/-1.8) . P was <0.05 for CAL between groups. Three and 12 months following adjunct ive systemic ofloxacin therapy, Aa was suppressed below detectable levels i n 22 of 22, test patients, whereas Aa could not be recovered in only 2 of t he 10 controls. (P <0.0001). Conclusions: Systemic ofloxacin as adjunct to open flap surgery is able to suppress A. actinomycetemcomitans below detectable level in patients harbor ing this organism at baseline.