Efficacy of subantimicrobial dosing with doxycycline - Point/counterpoint

Background. This article addresses: the role of subantimicrobial dosing wit h doxycycline , or SDD, in the treatment of chronic periodontitis. The auth ors discuss and debate 10 issues with regard to SDD's utility as an adjunct to scaling and root planing. Types of studies Reviewed. The authors reviewed reports of controlled clini cal trials that assessed the efficacy of SDD. The main focus of this articl e is data from the U.S. Food and Drug Administration's phase clinical trial that evaluated the efficacy of SDD in terms of alterations of probing dept h, clinical attachment levels and - disease progression. Results. The authors compared data from test groups, which underwent root-p laning plus SDD, with data from control groups, which underwent root planin g alone; The mean data suggest that SDD:provides a defined but improvement of periodontal status used in conjunction with scaling and root planing. Fu rthermore, several in vivo studies indicated that a nine-month course of SD D did not cause development of drug-resistant bacterial strains or alterati on of the subgingival microbiota. Clinical Implications. Some patients may benefit from SDD. However, there a re issues that should be clarified before widespread use of SDD is recommen ded for patients with chronic periodontitis. The evidence indicates that su ppression of the bacterial challenge, which reduces the host response, is t he most efficient way to control periodontal diseases.