Antimicrobial Resistance Linked With Severe Periodontitis

Dentistry Today

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Antimicrobial resistance is on the rise among German patients with severe periodontitis, according to the University of Bonn in research presented at the European Federation of Periodontology’s EuroPerio9 conference, June 20 to June 23 in Amsterdam.

“Antibiotic resistance is of enormous importance to dentistry, since the proportion of medically prescribed antibiotics attributable to dentistry is between 8% and 11.3% of the total (Norway, Canada, USA). In Germany, the percentage is about 8.8%,” said Karin Jepsen, DMD, associate professor at the university and lead author of the study.

“At present, most systemic periodontal antibiotic treatment is prescribed without guidance from a prior microbiologic analysis,” she said. “One of the risks of this approach is that the targeted periodontal pathogens are resistance or poorly susceptible to the antibiotic drug selected, affecting the efficacy of the antimicrobial therapy and increasing the risk of treatment failure.” 

Many clinical trials have shown that adjunctive systemic antibiotics combined with mechanical subgingival cleaning of the teeth offer additional clinical improvements compared to cleaning alone, especially in severe disease. But these results are difficult to translate to everyday practice because not all patients show the same degree of long-term clinical benefit, the researchers said. 

“In most cases, periodontitis can be managed by conventional scaling and root planing therapy, as well as improved oral hygiene measures (intraoral infection control,” Jepsen said. “Antibiotics should be restricted and used only in cases of severe periodontitis. If antibiotics are to be prescribed for patients with periodontitis, testing of antimicrobial susceptibility patterns is encouraged for a more targeted approach.”

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