It has long been questioned whether
antibiotics, used as a supplement to traditional
therapy, provide any lasting benefit in the treatment of
chronic periodontitis. This study was designed to evaluate
Spiramycin as an adjunct to scaling and
root planing in the treatment of advanced
chronic periodontitis. In total, 193 patients with advanced
periodontitis were recruited in seven centres using selection criteria previously described. After undergoing thorough scaling and
root planing, all patients randomly received either
Spiramycin, 1,500,000 international units, twice per day (IU, bid) for 14 days (96 patients), or a visually-identical placebo
capsule (97 patients). The clinical parameters measured were plaque index, crevicular fluid level, probing depths,
bleeding on probing and attachment level changes. Data was recorded at baseline, two-, eight-, 12- and 24-weeks visits. A total of 189 patients completed the study (96 placebo, 93
Spiramycin). Statistically significant differences in probing depth, favoring
Spiramycin, were seen at two weeks (p < 0.0125), eight weeks (p < 0.0020), 12 weeks (p < 0.0032) and 24 weeks (p < 0.0075).
Spiramycin also produced a significant improvement in attachment level at 12 weeks (p < 0.0146). All other clinical parameters showed no difference between
drug and placebo. This study shows that
Spiramycin, as an adjunct to thorough scaling and
root planing, provides a statistically significant improvement in probing depths for up to 24 weeks when compared with scaling and
root planing alone. Both longer studies and microbiologic evaluations are necessary to determine whether a more lasting benefit is possible.