Antibiotics in the Management of Periodontal Disease

Systemic antibiotics are increasingly used in the treatment of periodontal infections. Whilst these drugs are used mostly on an empirical basis, some physicians contend that rational use of antibiotics should be the norm due to their wide abuse and global emergence of antibiotic-resistant organisms. This is a review of the principles and rational antimicrobial therapy, treatment goals, drug delivery routes and various antibiotics used in the management of periodontal diseases. The available data indicate, in general, that mechanical periodontal treatment alone is adequate to ameliorate or resolve the clinical condition in most cases, but adjunctive antimicrobial agents, delivered systemically, can enhance the effect of therapy in specific situations. This is particularly true for aggressive periodontitis in patients with generalised systemic disease that may affect host resistance, and in case of poor response to conventional mechanical therapy. This article provides an update on systemic antibiotic therapy for the treatment of periodontitis.