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Review

Comparing the Antimicrobial In Vitro Efficacy of Amoxicillin/Metronidazole against Azithromycin—A Systematic Review

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Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, CH-8032 Zurich, Switzerland
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Private Practice, Zahnmedizin Wiesental, CH-9100 Herisau, Switzerland
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Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, CH-4056 Basel, Switzerland
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Statistical Services, Center of Dental Medicine, University of Zurich, CH-8032 Zurich, Switzerland
*
Author to whom correspondence should be addressed.
Dent. J. 2018, 6(4), 59; https://doi.org/10.3390/dj6040059
Received: 16 August 2018 / Revised: 19 September 2018 / Accepted: 25 September 2018 / Published: 20 October 2018
(This article belongs to the Section Oral Hygiene, Periodontology and Peri-implant Diseases)
On account of its proven clinical efficacy, the combination of systemically administered amoxicillin and metronidazole is frequently adjuncted to non-operative periodontal therapy and well documented. Potential drawbacks of this regimen, e.g., side effects and problems with the compliance, led to an ongoing search for alternatives. Azithromycin, an antibiotic extensively used in general medicine, has recently found its niche in periodontal therapy as well. This systematic review aimed to analyze the in vitro antimicrobial efficacy of amoxicillin plus metronidazole versus azithromycin. For this purpose, a systematic literature search was performed, and studies published up to 29 March 2018 referenced in Medline, Embase, Cochrane, and Biosis were independently screened by two authors. An additional hand search was performed and studies focusing on the evaluation of in vitro antimicrobial efficacy of amoxicillin + metronidazole or azithromycin on bacteria from the subgingival biofilm were included. English and German language research reports were considered. From 71 identified articles, only three articles were eligible for inclusion. These studies showed heterogeneity in terms of analytical methods and strains explored. However, all studies used multispecies biofilm models for analysis of the antimicrobial activity. Unanimously, studies reported on more pronounced antimicrobial effects when applying the combination of amoxicillin + metronidazole, compared to azithromycin. Based on the few studies available, the combination of amoxicillin + metronidazole seemed to display higher antimicrobial efficacy in vitro than azithromycin. View Full-Text
Keywords: systematic review; azithromycin; macrolide; amoxicillin; metronidazole; antimicrobial; in vitro systematic review; azithromycin; macrolide; amoxicillin; metronidazole; antimicrobial; in vitro
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MDPI and ACS Style

Kaufmann, M.; Lenherr, P.; Walter, C.; Thurnheer, T.; Attin, T.; Wiedemeier, D.B.; Schmidlin, P.R. Comparing the Antimicrobial In Vitro Efficacy of Amoxicillin/Metronidazole against Azithromycin—A Systematic Review. Dent. J. 2018, 6, 59. https://doi.org/10.3390/dj6040059

AMA Style

Kaufmann M, Lenherr P, Walter C, Thurnheer T, Attin T, Wiedemeier DB, Schmidlin PR. Comparing the Antimicrobial In Vitro Efficacy of Amoxicillin/Metronidazole against Azithromycin—A Systematic Review. Dentistry Journal. 2018; 6(4):59. https://doi.org/10.3390/dj6040059

Chicago/Turabian Style

Kaufmann, Manuela, Patrik Lenherr, Clemens Walter, Thomas Thurnheer, Thomas Attin, Daniel B. Wiedemeier, and Patrick R. Schmidlin 2018. "Comparing the Antimicrobial In Vitro Efficacy of Amoxicillin/Metronidazole against Azithromycin—A Systematic Review" Dentistry Journal 6, no. 4: 59. https://doi.org/10.3390/dj6040059

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