Antibiotics

Editorial

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4 pages, 195 KiB

Open AccessEditorial

Antibiotics and Antimicrobials for Treatment of the Oral Microbiota: Myths and Facts in Research and Clinical Practice

by Gaetano Isola

Antibiotics 2020, 9(2), 95; https://doi.org/10.3390/antibiotics9020095 - 22 Feb 2020

Cited by 5 | Viewed by 4393

Abstract

In the dental field, the most common oral diseases include periodontitis, apical periodontitis, abscesses, phlegmons and pulpits, all of which are determined by the same aetiological factor, bacterial infections. For these reasons, it is important to choose the right approach through a target [...] Read more.

In the dental field, the most common oral diseases include periodontitis, apical periodontitis, abscesses, phlegmons and pulpits, all of which are determined by the same aetiological factor, bacterial infections. For these reasons, it is important to choose the right approach through a target antibiotic therapy against oral bacteria. More specifically, during periodontitis, antibiotics are used, often in association with periodontal debridement, to reduce disease-associated periodontopathogens. However, international guidelines are not unanimous in recommending the use of local and/or systemic antimicrobials to reduce infection by oral bacteria, especially in cases in which there is a danger of spreading systemic infection such as cellulitis, diffuse swelling, and abscesses. The lack of consensus is mainly due to the side effects of antibiotic therapy in dentistry, maybe due to recent scientific evidence regarding the development of bacterial resistance to antibiotics. Therefore, the purpose of this editorial is to analyze the therapeutic effects of antibiotics against the main forms of oral and periodontal diseases, and whether there is a significant clinical benefit, especially in the long term, of antimicrobial therapies in dentistry. The most recent evidence regarding antimicrobial agents will also be discussed. Full article

(This article belongs to the Special Issue Antibiotics and Antimicrobials in Dentistry)

Research

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12 pages, 4272 KiB

Open AccessArticle

The Effectiveness of Chlorhexidine and Air Polishing System in the Treatment of Candida albicans Infected Dental Implants: An Experimental In Vitro Study

by Pier Carmine Passarelli, Marta De Leonardis, Giovan Battista Piccirillo, Viviana Desantis, Raffaele Papa, Edoardo Rella, Giuseppe Niccolò Mastandrea Bonaviri, Piero Papi, Giorgio Pompa, Guido Pasquantonio, Paolo Francesco Manicone and Antonio D’Addona

Antibiotics 2020, 9(4), 179; https://doi.org/10.3390/antibiotics9040179 - 14 Apr 2020

Cited by 12 | Viewed by 3954

Abstract

Background: Peri-implantitis is an inflammatory disease with an increasing diffusion rate which can affect the long-term survival of a prosthetic rehabilitation. The present study focused on the decontaminating efficacy of chlorhexidine and air polishing system with sodium bicarbonate powder against Candida albicans, a [...] Read more.

Background: Peri-implantitis is an inflammatory disease with an increasing diffusion rate which can affect the long-term survival of a prosthetic rehabilitation. The present study focused on the decontaminating efficacy of chlorhexidine and air polishing system with sodium bicarbonate powder against Candida albicans, a microorganism which seems to have a superinfecting opportunistic role in the pathology. The aim of the authors was to investigate and compare the effectiveness of these treatments, commonly used in clinical practice. Methods: An in vitro study was conducted to analyze the effects of two widely used therapeutic aids for the disinfection of affected titanium implants: chlorhexidine (CHX) and air polishing with sodium bicarbonate powder (P). A qualitative and quantitative comparative analysis of the residual biofilm was carried out using a colorimetric assay (XTT) and scanning electron microscopy (SEM) observation. The experiment was conducted both on machined titanium surfaces and on rough sandblasted ones with the aim of bringing out differences in the therapeutic outcomes concerning the superficial texture of the implant. The null hypothesis was that no difference could be detected between the samples, regarding both the treatments performed and the nano-structural features of titanium. Results: The best results (on both types of implant surfaces) were obtained when combining the use of chlorhexidine and air polishing (C + P). A linear decrease in the optical density (OD) values recorded at three different time points (30 s, 1 min, 5 min) was also observed passing from the first to the last one. When observed under scanning electron microscope rough surfaces showed an extensive and highly structured biofilm, more complex if compared to the one encountered when analyzing machined implants. Conclusions: the present pilot study showed that rough surfaces can promote fungal adhesion and eventually hinder the outcome of a decontaminating treatment. For this purpose, the physio-chemical technique is always more efficient if compared to a single-technique approach regardless of the surface characteristics. Full article

(This article belongs to the Special Issue Antibiotics and Antimicrobials in Dentistry)

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14 pages, 2981 KiB

Open AccessArticle

Taurolidine Acts on Bacterial Virulence Factors and Does Not Induce Resistance in Periodontitis-Associated Bacteria—An In-Vitro Study

by Sabrina Radakovic, Nicola Andreoli, Simon Schmid, Sandor Nietzsche, Jürg Zumbrunn, Anton Sculean and Sigrun Eick

Antibiotics 2020, 9(4), 166; https://doi.org/10.3390/antibiotics9040166 - 7 Apr 2020

Cited by 4 | Viewed by 3249

Abstract

The aims of the present study were: (a) to determine the mechanism of action of taurolidine against bacterial species associated with periodontal disease, and (b) to evaluate the potential development of resistance against taurolidine as compared with minocycline. After visualizing the mode of [...] Read more.

The aims of the present study were: (a) to determine the mechanism of action of taurolidine against bacterial species associated with periodontal disease, and (b) to evaluate the potential development of resistance against taurolidine as compared with minocycline. After visualizing the mode of action of taurolidine by transmission electron micrographs, the interaction with most important virulence factors (lipopolysaccharide (LPS), Porphyromonas gingivalis gingipains, Aggregatibacter actinomycetemcomitans leukotoxin), was analyzed. Then, 14 clinical isolates from subgingival biofilm samples were transferred on agar plates containing subinhibitory concentrations of taurolidine or minocycline up to 50 passages. Before and after each 10 passages, minimal inhibitory concentrations (MICs) were determined. Increasing MICs were screened for efflux mechanism. Taurolidine inhibited in a concentration-dependent manner the activities of LPS and of the arginine-specific gingipains; however, an effect on A. actinomycetemcomitans leukotoxin was not detected. One P. gingivalis strain developed a resistance against taurolidine, which was probably linked with efflux mechanisms. An increase of MIC values of minocycline occurred in five of the 14 included strains after exposure to subinhibitory concentrations of the antibiotic. The present results indicate that: (a) taurolidine interacts with LPS and gingipains, and (b) development of resistance seems to be a rare event when using taurolidine. Full article

(This article belongs to the Special Issue Antibiotics and Antimicrobials in Dentistry)

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20 pages, 2012 KiB

Open AccessArticle

Solidago virgaurea L. Plant Extract Targeted against Candida albicans to Reduce Oral Microbial Biomass: A Double Blind Randomized Trial on Healthy Adults

by Isabelle Prêcheur, Yohan Rolland, Lilia Hasseine, François Orange, Adeline Morisot and Anne Landreau

Antibiotics 2020, 9(4), 137; https://doi.org/10.3390/antibiotics9040137 - 25 Mar 2020

Cited by 4 | Viewed by 4144

Abstract

Oral microbiome plays an important part on oral health and endogenous bacteria and fungi should not be eradicated. However, their proliferation must be controlled by oral hygiene care. In vitro, Solidago virgaurea ssp. virgaurea L. (SV) plant extract inhibits the adherence and hyphal [...] Read more.

Oral microbiome plays an important part on oral health and endogenous bacteria and fungi should not be eradicated. However, their proliferation must be controlled by oral hygiene care. In vitro, Solidago virgaurea ssp. virgaurea L. (SV) plant extract inhibits the adherence and hyphal formation of a fungus, Candida albicans. It reduces the biomass of Candida-bacterial biofilms but not fungal or bacterial growth. Unlike chemical antiseptics, like triclosan and chlorhexidine for instance, SV is a plant extract easily biodegradable. The purpose of this study was to assess the in vivo effectiveness of SV extract in reducing oral biomass. A randomized, double-blind clinical study, with dental plaque evaluation designed to assess the effectiveness of a fluorinated toothpaste containing SV (Bucovia™, Givaudan, Vernier, Switzerland) was conducted. Sixty-six subjects (SV group n = 33 vs. control n = 33) brushed their teeth twice a day for a 4-week period. Supragingival dental plaque was sampled. Total bacterial load (broad spectral bacterial quantitative Polymerase Chain Reaction (qPCR)), C. albicans and seven bacterial species were quantified by qPCR. In the Intervention group, there was a decrease of Total bacterial load (ΔD0D28 p = 0.005 and ΔD14D28 p = 0.026), Streptococcus mutans (ΔD0D14 p = 0.024) and C. albicans (ΔD0D28 p = 0.022). In the Control group Total bacterial load tended to decrease from baseline to day 28 (ΔD0D28 p = 0.062 and ΔD14D28 p = 0.009). Plaque Index and Gingival Index improved in both groups. Full article

(This article belongs to the Special Issue Antibiotics and Antimicrobials in Dentistry)

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11 pages, 230 KiB

Open AccessArticle

Comparative In Vitro Resistance of Human Periodontal Bacterial Pathogens to Tinidazole and Four Other Antibiotics

by Thomas E. Rams, Jacqueline D. Sautter and Arie J. van Winkelhoff

Antibiotics 2020, 9(2), 68; https://doi.org/10.3390/antibiotics9020068 - 7 Feb 2020

Cited by 28 | Viewed by 4984

Abstract

The in vitro resistance of selected red/orange complex periodontal pathogens to tinidazole was compared with four other antibiotics. Subgingival biofilm samples from 88 adults with severe periodontitis were anaerobically incubated on enriched Brucella blood agar with and without supplementation with tinidazole (16 mg/L), [...] Read more.

The in vitro resistance of selected red/orange complex periodontal pathogens to tinidazole was compared with four other antibiotics. Subgingival biofilm samples from 88 adults with severe periodontitis were anaerobically incubated on enriched Brucella blood agar with and without supplementation with tinidazole (16 mg/L), metronidazole (16 mg/L), amoxicillin (8 mg/L), doxycycline (4 mg/L), or clindamycin (4 mg/L). Growth of Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia/nigrescens, Parvimonas micra, Fusobacterium nucleatum, Streptococcus constellatus, or Campylobacter rectus on antibiotic-supplemented plates indicated their in vitro antibiotic resistance. Tinidazole inhibited all test species, except P. intermedia/nigrescens, P. micra, and S. constellatus in 3.8%, 10.2%, and 88.9% of species-positive patients, respectively. Significantly fewer patients yielded tinidazole-resistant test species, and had significantly lower subgingival proportions of tinidazole-resistant organisms, than patients with amoxicillin, doxycycline, or clindamycin-resistant species, but not those with metronidazole-resistant strains. Joint in vitro species resistance to tinidazole and amoxicillin, or metronidazole and amoxicillin, was rare. Tinidazole performed in vitro similar to metronidazole, and markedly better than amoxicillin, doxycycline, or clindamycin, against fresh clinical isolates of red/orange complex periodontal pathogens. As a result of its similar antimicrobial spectrum, and more convenient once-a-day oral dosing, tinidazole should be considered in place of metronidazole for systemic periodontitis drug therapy. Full article

(This article belongs to the Special Issue Antibiotics and Antimicrobials in Dentistry)

11 pages, 230 KiB

Open AccessArticle

Factors Influencing the Onset of Intra- and Post- Operative Complications Following Tooth Exodontia: Retrospective Survey on 1701 Patients

by Erica Vettori, Fulvia Costantinides, Vanessa Nicolin, Roberto Rizzo, Giuseppe Perinetti, Michele Maglione and Roberto Di Lenarda

Antibiotics 2019, 8(4), 264; https://doi.org/10.3390/antibiotics8040264 - 13 Dec 2019

Cited by 14 | Viewed by 7162

Abstract

Complications after tooth extraction may occur because of several factors correlated to the patient’s medical history, surgical site or type of intervention. The aim of this retrospective cohort study was to evaluate type and frequency of complications after exodontic surgery, its correlation with [...] Read more.

Complications after tooth extraction may occur because of several factors correlated to the patient’s medical history, surgical site or type of intervention. The aim of this retrospective cohort study was to evaluate type and frequency of complications after exodontic surgery, its correlation with antibiotic administration and between patient’s related systemic factors. From June 2015 until February 2016 1701 exodontic interventions, for a total of 2322 extracted teeth, were carried out at the Unit of Oral Surgery in Trieste. Descriptive statistic, and backward multiple logistic regressions were performed to identify the variables associated with the presence of post-operative alveolitis or any other post-operative complication. The presence of coagulopathy and smoking habit were related to high risk of post-operative alveolitis (OR = 5.51, p = 0.035 and OR = 2.5, p = 0.029, respectively). Tooth fracture was found to be correlated with higher probability of post-operative alveolitis (p = 0.001) and concomitant chemotherapy put at a higher risk post-operative complications, including alveolitis (OR = 29.5, p = 0.018). According to the present results, antibiotic consumption did not seem to reduce the incidence of post-operative infective complications (alveolitis). A careful analysis of medical history, the adequate surgical technique, and the correct instructions in post-surgical behavior, prevent the insurgence of intra and post-operative complications. Full article

(This article belongs to the Special Issue Antibiotics and Antimicrobials in Dentistry)

10 pages, 3729 KiB

Open AccessArticle

Er,Cr:YSGG Laser-Activation Enhances Antimicrobial and Antibiofilm Action of Low Concentrations of Sodium Hypochlorite in Root Canals

by Pablo Betancourt, Josep María Sierra, Octavi Camps-Font, Josep Arnabat-Domínguez and Miguel Viñas

Antibiotics 2019, 8(4), 232; https://doi.org/10.3390/antibiotics8040232 - 22 Nov 2019

Cited by 16 | Viewed by 4387

Abstract

The onset and persistence of endodontic infections due to residual biofilm after chemical disinfection promotes secondary bacterial infection. Alternative methods to disinfect operated root canals are a matter of great interest. The aim was to evaluate the antibacterial effectiveness of sodium hypochlorite (NaOCl) [...] Read more.

The onset and persistence of endodontic infections due to residual biofilm after chemical disinfection promotes secondary bacterial infection. Alternative methods to disinfect operated root canals are a matter of great interest. The aim was to evaluate the antibacterial effectiveness of sodium hypochlorite (NaOCl) at low concentrations activated by the Er,Cr:YSGG laser-activated irrigation (LAI) against 10-day-old intracanal Enterococcus faecalis biofilm. Biofilms were formed inside the root canals and divided into 7 groups (n13): 0.5% NaOCl + Er,Cr:YSGG; Saline + Er,Cr:YSGG; 0.5% NaOCl + syringe irrigation(SI); 2.5% NaOCl + SI; 5% NaOCl + SI; positive and negative controls. Bacterial survivors were counted and specimens visualized under scanning electron and confocal laser scanning microscopy. Treatments with 0.5% NaOCl + Er,Cr:YSGG and 2.5% NaOCl + SI gave a significant reduction in the number of CFU/mm². Moreover, scanning electron microscopy and confocal laser scanning microscopy imaging confirmed and reinforced bacteriological data. Thus, Er,Cr:YSGG LAI proved to be able to improve the intracanal distribution of 0.5% NaOCl after 60 s of activation, reaching the same level of effectiveness than 2.5% NaOCl. This is regarded as of clinical interest, since working with lower concentrations may contribute to reduce undesired effects. Full article

(This article belongs to the Special Issue Antibiotics and Antimicrobials in Dentistry)

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8 pages, 1017 KiB

Open AccessArticle

Antibiofilm Activity of Three Different Irrigation Techniques: An in Vitro Study

by Caterina Eneide, Raffaella Castagnola, Cecilia Martini, Nicola Maria Grande, Francesca Bugli, Romeo Patini, Massimo Cordaro, Maurizio Sanguinetti, Giovanni Olivi, Gaetano Isola and Luca Marigo

Antibiotics 2019, 8(3), 112; https://doi.org/10.3390/antibiotics8030112 - 9 Aug 2019

Cited by 18 | Viewed by 4263

Abstract

The microbial infection of the endodontic space occurs in a necrotic tooth as a result of dental caries, trauma, periodontal disease, or previous root canal therapy. The disruption of the biofilms and the reduction of the bacterial load inside root canals are crucial [...] Read more.

The microbial infection of the endodontic space occurs in a necrotic tooth as a result of dental caries, trauma, periodontal disease, or previous root canal therapy. The disruption of the biofilms and the reduction of the bacterial load inside root canals are crucial for the success of root canal therapy. The aim of this study was to compare, in vitro, the antibiofilm efficacy of a novel passive sonic irrigation (PSI) device with passive ultrasonic irrigation (PUI) and conventional needle irrigation (CNI). Forty-four single-rooted human teeth were inoculated with a culture of E. faecalis for 28 days. The specimens were randomly divided into three groups: PUI, CNI, and PSI (n = 12). The activation protocols were performed using both 17% EDTA and 5.25% NaOCl. Residual bacterial biofilm was taken by means of a canal brush and colony-forming unit (CFU) were counted. The data were analyzed using one-way ANOVA and Games-Howell’s post hoc tests. A major reduction in CFU was observed in the PSI and PUI groups, in comparison with the CNI group. No difference was found (p > 0.05) in terms of CFU reduction between PSI and PUI. PSI could be as effective as PUI in the removal of bacterial biofilms from straight root canals. Full article

(This article belongs to the Special Issue Antibiotics and Antimicrobials in Dentistry)

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12 pages, 875 KiB

Open AccessArticle

Evaluation and Comparison of Antibacterial Efficacy of Herbal Extracts in Combination with Antibiotics on Periodontal pathobionts: An in vitro Microbiological Study

by Shahabe Abullais Saquib, Nabeeh Abdullah AlQahtani, Irfan Ahmad, Mohammed Abdul Kader, Sami Saeed Al Shahrani and Elyas Ali Asiri

Antibiotics 2019, 8(3), 89; https://doi.org/10.3390/antibiotics8030089 - 1 Jul 2019

Cited by 64 | Viewed by 11245

Abstract

Background: In the past few decades focus of research has been toward herbal medicines because of growing bacterial resistance and side effects of antimicrobial agents. The extract derived from the plants may increase the efficacy of antibiotics when used in combination against pathogenic [...] Read more.

Background: In the past few decades focus of research has been toward herbal medicines because of growing bacterial resistance and side effects of antimicrobial agents. The extract derived from the plants may increase the efficacy of antibiotics when used in combination against pathogenic bacteria. In the current study, the synergistic antibacterial efficacy of plant extracts in combination with antibiotics has been assessed on selected periodontal pathogens. Methods: Ethanolic extracts were prepared from Salvadora persica (Miswak) and Cinnamomum zeylanicum (Ceylon cinnamon), by the soxhalate method. Plaque samples were collected from clinical periodontitis patients to isolate and grow the periodontal pathobionts under favorable conditions. Susceptibility of bacteria to the extracts was assessed by gauging the diameter of the inhibition zones. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of plant extracts were determined against each bacterium. Synergistic activity of plants extract in combination with antibiotics against the bacteria was also assessed by measuring the diameter of the inhibition zones. Results: Ethanolic extract of both the plants showed an inhibitory effect on the proliferation and growth of all four strains of periodontal pathobionts. Maximum antibacterial activity was exhibited by C. zeylanicum against Tannerella forsythia (MIC = 1.56 ± 0.24 mg/mL, MBC = 6.25 ± 0.68 mg/mL), whereas among all the studied groups the minimum activity was reported by C. zeylanicum against Aggregatibacter actinomycetemcomitans the (MIC = 12.5 ± 3.25 mg/mL, MBC = 75 ± 8.23 mg/mL). Combination of herbal extracts with different antibiotics revealed a synergistic antibacterial effect. The best synergism was exhibited by S. persica with metronidazole against A. actinomycetemcomitans (27 ± 1.78). Conclusions: Current in vitro study showed variable antibacterial activity by experimented herbal extracts against periodontal pathobionts. The synergistic test showed significant antibacterial activity when plant extracts were combined with antibiotics. Full article

(This article belongs to the Special Issue Antibiotics and Antimicrobials in Dentistry)

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14 pages, 3095 KiB

Open AccessArticle

A Topical Desiccant Agent in Association with Manual Debridement in the Initial Treatment of Peri-Implant Mucositis: A Clinical and Microbiological Pilot Study

by Giorgio Lombardo, Annarita Signoriello, Giovanni Corrocher, Caterina Signoretto, Gloria Burlacchini, Alessia Pardo and Pier Francesco Nocini

Antibiotics 2019, 8(2), 82; https://doi.org/10.3390/antibiotics8020082 - 18 Jun 2019

Cited by 13 | Viewed by 4937

Abstract

In patients presenting mucositis, effective sub-gingival debridement is crucial to prevent peri-implantitis. The aim of this randomized study was to assess the three-month (T1) effects of a locally delivered liquid desiccant agent with molecular hygroscopic properties, in association with manual debridement, at sites [...] Read more.

In patients presenting mucositis, effective sub-gingival debridement is crucial to prevent peri-implantitis. The aim of this randomized study was to assess the three-month (T1) effects of a locally delivered liquid desiccant agent with molecular hygroscopic properties, in association with manual debridement, at sites with peri-implant mucositis. Twenty-three patients presenting at least one implant with no radiographically detectable bone loss, a pocket probing depth (PPD) ≥ 4 mm, and bleeding on probing (BOP), were included. At baseline (T0), patients were randomly assigned to receive the aforementioned desiccant agent before debridement (Test-Group), or a Chlorhexidine 1% disinfectant gel after debridement (Control-Group). Treatments were repeated after seven and 14 days. Peri-implant soft tissue assessment [PPD, BOP, Modified Bleeding Index (mBI), Visible Plaque Index (VPI), and Modified Plaque Index (mPLI)] and microbial sampling were performed at T0 and T1. At T1 the Test-Group presented significantly greater reductions for BOP, mBI, VPI, and mPLI. Concerning the deepest sites of the treated implants, both groups showed statistically significant reductions for BOP and mBI between T0 and T1. Furthermore, the Test-Group exhibited a significant decrease in anaerobic bacteria. Despite these valid outcomes, a complete resolution of the inflammatory conditions was not achieved by any of the groups. Full article

(This article belongs to the Special Issue Antibiotics and Antimicrobials in Dentistry)

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Review

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15 pages, 1517 KiB

Open AccessReview

The Effect of Different Antibiotic Regimens on Bacterial Resistance: A Systematic Review

by Romeo Patini, Gilda Mangino, Leonardo Martellacci, Gianluca Quaranta, Luca Masucci and Patrizia Gallenzi

Antibiotics 2020, 9(1), 22; https://doi.org/10.3390/antibiotics9010022 - 8 Jan 2020

Cited by 46 | Viewed by 9121

Abstract

Background and objectives: Infections caused by resistant bacteria are a growing public health problem that is linked to many different causes, among them the antibiotics’ incorrect use plays an important role. According to the World Health Organization (WHO) the most dangerous behaviors are [...] Read more.

Background and objectives: Infections caused by resistant bacteria are a growing public health problem that is linked to many different causes, among them the antibiotics’ incorrect use plays an important role. According to the World Health Organization (WHO) the most dangerous behaviors are the early interruption of antibiotic therapy and the use of molecules without appropriate prescription. The authors conducted a systematic review to assess if antibiotic prescription with different regimens is connected to the onset of bacterial resistance. Methods: The authors performed an electronic and manual literature search on four databases (Web of Science, Scopus, PubMed, and Cochrane Register of Controlled Trials) from their inception to 15 June 2019. The date of the last search was 27 November 2019. Any article comparing cultural or genic analysis of resistance in patients that took antibiotics with at least two different regimens was included. No language restrictions were applied. Risk of bias for randomized controlled trials (RCTs) was assessed using the Cochrane collaboration’s tool whereas case-control and cohort studies were evaluated through the Newcastle–Ottawa scale. Results: The initial search resulted in a total of 1744 titles. After careful evaluation of all results, only three studies satisfied the outcome of the present review. From the qualitative analysis of data, it emerges that even if antibiotics are administered for a shorter period than the conventional one the species that inhabit the oral cavity can adapt quickly and express genes of antibiotic resistance. Additional evidence from this analysis is that not only does the proportion of resistant bacteria increase in the oral cavity, but also in more distant districts such as the intestine. Conclusions: Despite the great number of studies retrieved by electronic databases only few studies investigated the target of this review. The reason for this evidence is that it is not ethical to investigate and compare different antibiotic regimens, shorter or longer than the appropriate one. This evidence is applicable both to prophylactic administrations and to those aimed at treating infections. Besides this, the WHO affirms that, in the absence of infective complications, the prescription of antibiotic after every type of surgical intervention cannot be admitted and that studies dealing with antibiotic regimens that do not comply with drug’s pharmacodynamics characteristics cannot be ethically admitted. PROSPERO acknowledgement of receipt [149149]. Full article

(This article belongs to the Special Issue Antibiotics and Antimicrobials in Dentistry)

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26 pages, 1570 KiB

Open AccessReview

Commercial Local Pharmacotherapeutics and Adjunctive Agents for Nonsurgical Treatment of Periodontitis: A Contemporary Review of Clinical Efficacies and Challenges

by Oi Leng Tan, Syarida Hasnur Safii and Masfueh Razali

Antibiotics 2020, 9(1), 11; https://doi.org/10.3390/antibiotics9010011 - 30 Dec 2019

Cited by 26 | Viewed by 9491

Abstract

Periodontal infections tend to be site-specific, mostly confined to the periodontal pocket. With the surge of antibiotic-resistant bacteria, the trend is shifting towards other therapeutic modalities, especially locally delivered approaches that include other pharmacotherapeutic drugs and medical devices. This narrative review aimed to [...] Read more.

Periodontal infections tend to be site-specific, mostly confined to the periodontal pocket. With the surge of antibiotic-resistant bacteria, the trend is shifting towards other therapeutic modalities, especially locally delivered approaches that include other pharmacotherapeutic drugs and medical devices. This narrative review aimed to provide insights into the clinical efficacy of local drug delivery and adjunctive agents used in nonsurgical management of periodontitis. Electronic (PubMed/MEDLINE, CENTRAL, and EMBASE) and bibliographic searches of past systematic reviews were carried out to identify previous publications on the topic. Only relevant literature and randomized controlled trials published in English were selected. In addition, a literature review was developed based on the selected articles. Experimental drugs or agents were excluded. This review highlights the clinically proven and commercially available therapeutic agents related to the management of periodontal disease with comparisons of their clinical efficacies and challenges. A vast array of commercial local pharmacotherapeutic agents had been clinically tested, but the methodologies and clinical results varied within and between each agent used, causing difficulty in drawing conclusions and providing support to the superiority of one agent over another. Considering the benefit–cost ratio with the modest clinical results, the long-term usefulness of these agents remains debatable. Full article

(This article belongs to the Special Issue Antibiotics and Antimicrobials in Dentistry)

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14 pages, 595 KiB

Open AccessReview

Antibiotic Prophylaxis on Third Molar Extraction: Systematic Review of Recent Data

by Gabriele Cervino, Marco Cicciù, Antonio Biondi, Salvatore Bocchieri, Alan Scott Herford, Luigi Laino and Luca Fiorillo

Antibiotics 2019, 8(2), 53; https://doi.org/10.3390/antibiotics8020053 - 2 May 2019

Cited by 71 | Viewed by 11444

Abstract

The aim of this paper was to highlight the most widely antibiotic protocols applied to the dental field, especially in the surgical treatment of impacted wisdom teeth. Once these protocols were screened, all the possible advantages or disadvantages for each drug and each [...] Read more.

The aim of this paper was to highlight the most widely antibiotic protocols applied to the dental field, especially in the surgical treatment of impacted wisdom teeth. Once these protocols were screened, all the possible advantages or disadvantages for each drug and each posology were recorded in this review. In recent years, the need to use these protocols has been debated in the literature. The data obtained by this review underlined how antibiotic protocols applied to oral surgery treatments only included surgeries performed on patients who did not present other systemic pathologies. The first literature review obtained 140 results, and then after the application of the inclusion criteria, 12 papers were selected. The results showed that the most commonly used protocol involved the use of penicillin and clavulanate, obtaining safe clinical and prophylactic results in the management of infections. This widely used protocol seems to guarantee high predictability and safety. The presented review highlights the current possibility of antibiotic resistance affecting patients due to drug misuse. Further clinical studies are required to state specific guidelines; however, oral surgeons involved in third molar surgery should evaluate the local and general health conditions of the patients before suggesting any drug measures for patients. Full article

(This article belongs to the Special Issue Antibiotics and Antimicrobials in Dentistry)

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Other

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9 pages, 1015 KiB

Open AccessBrief Report

Tolerance and Persister Formation in Oral Streptococci

by Stephanie Suppiger, Monika Astasov-Frauenhoffer, Irene Schweizer, Tuomas Waltimo and Eva M. Kulik

Antibiotics 2020, 9(4), 167; https://doi.org/10.3390/antibiotics9040167 - 8 Apr 2020

Cited by 5 | Viewed by 2641

Abstract

The aim of this study was to analyze the potential influence of long-term exposure in subinhibitory concentrations of chlorhexidine on the emergence of tolerant and/or persistent cells in oral streptococci. The two oral streptococcal isolates S. mutans ATCC25175 and S. sobrinus ATCC33402 were [...] Read more.

The aim of this study was to analyze the potential influence of long-term exposure in subinhibitory concentrations of chlorhexidine on the emergence of tolerant and/or persistent cells in oral streptococci. The two oral streptococcal isolates S. mutans ATCC25175 and S. sobrinus ATCC33402 were incubated, after long-term subinhibitory exposure to chlorhexidine, in liquid growth media containing high concentrations of chlorhexidine. A distinct subpopulation of more chlorhexidine-tolerant cells could be detected in streptococci that had been previously exposed to subinhibitory concentrations of chlorhexidine but not in the control strains. These more biocide-tolerant and persisting microbial subpopulations might also arise in vivo. Therefore, the rational and proper use of antimicrobials in dentistry, especially when used over a long period of time, is crucial. Full article

(This article belongs to the Special Issue Antibiotics and Antimicrobials in Dentistry)

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8 pages, 1458 KiB

Open AccessBrief Report

Antibiotic Susceptibility Patterns of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis Strains from Different Decades

by Eva M. Kulik, Thomas Thurnheer, Lamprini Karygianni, Clemens Walter, Anton Sculean and Sigrun Eick

Antibiotics 2019, 8(4), 253; https://doi.org/10.3390/antibiotics8040253 - 6 Dec 2019

Cited by 25 | Viewed by 6178

Abstract

The aim of this study was to determine the antibiotic susceptibility patterns of 57 Aggregatibacter actinomycetemcomitans and 56 Porphyromonas gingivalis strains isolated from subgingival biofilm samples of periodontitis patients in Switzerland from 1980 to 2017. The minimal inhibitory concentrations (MIC) of the most [...] Read more.

The aim of this study was to determine the antibiotic susceptibility patterns of 57 Aggregatibacter actinomycetemcomitans and 56 Porphyromonas gingivalis strains isolated from subgingival biofilm samples of periodontitis patients in Switzerland from 1980 to 2017. The minimal inhibitory concentrations (MIC) of the most commonly used antibiotics in periodontal therapy (amoxicillin, metronidazole, azithromycin, and doxycycline) or in severe body infections (amoxicillin/clavulanic acid, clindamycin, ertapenem, and moxifloxacin) were determined. Furthermore, all the strains were screened for beta-lactamase activity and the presence of selected resistance genes (cfxA, ermF, and tetQ). Overall, there was no significant increase in MIC values over the 37‑year period. Two of the most recent P. gingivalis isolates yielded the highest MIC values. The first isolate was ermF-positive with MIC values >8 µg/mL, 2 µg/mL, and 0.25 µg/mL for clindamycin, azithromycin, and moxifloxacin, respectively. The second isolate showed a high MIC value of 4 µg/mL for moxifloxacin, which was associated with a confirmed single-point mutation in the quinolone resistance-determining region (QRDR) of the gyrA gene. Although there was no significant increase in the antibiotic resistance among the oral bacterial isolates tested, the detection of resistant P. gingivalis isolates underlines the need to optimize the antibiotic therapeutic protocols in dentistry. Full article

(This article belongs to the Special Issue Antibiotics and Antimicrobials in Dentistry)

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