Clinical and laboratory assessment of the application efficacy of antibacterial combinations in the treatment of chronic generalized periodontitis

Abstract

Aim. To determine the efficacy of the combination of metronidazole and co-trimoxazole in the treatment of chro­nic generalized periodontitis.

Methods. The studies included patients with slight and moderate chronic generalized periodontitis without concomitant pathology. Patients were divided into two groups with similar age and severity of periodontal diseases. In the first group, metronidazole was administered into the periodontal pocket; in the second group co-trimoxa­zole and metronidazole combination was used. Oral fluid testing was used to detect ureolytic and glycolytic activity, malondialdehyde (MDA) content, conjugated dienes, catalase activity, Salivary Secretory Immunoglobulin (SIgA) and Lysozyme. Changes in periodontal disease were assessed before and after treatment. The duration of treatment was 12 days.

Results. Co-trimoxazole and metronidazole combination more effectively stimulated ureolytic activity and reduced glycolytic effect. It had a more effective antioxidant effect that manifested in: a statistically significant decrease in malondialdehyde levels by 32.8% (p <0.01) and by 36.6% (p <0.01) in patients with slight and moderate periodontitis, respectively; decrease in diene conjugates by 25.0% (p <0.001) and 37.7% (p <0.001); and increased catalase activity 2.6 and 2.9 times (p <0.001). After treatment, it was revealed an increase in lysozyme activity by 11.3% and 17.6% (р <0,001) in patients with slight and moderate periodontitis, respectively, and increase secretory IgA le­vels by 37.4% (p <0.001) and 53.2% (p <0.001). In the first group, the amount of SIgA in the oral fluid increases by 35.8% (p <0.001), and by 45.6% (p <0.001) compared to the value before treatment in patients with slight and mo­derate periodontitis, and in the second group by 37.4% (p <0.001) and 53.2% (p <0.001), respectively.

Conclusion. The combined treatment with co-trimoxazole + metronidazole leads to the positive changes in the studied parameters causes rapid disappearance of the symptoms characteristic of chronic generalized periodontitis; this 2-drug combination is recommended to be included in the complex therapeutic measures for inflammatory periodontal diseases.

Keywords

chronic generalized periodontitis / metronidazole / co-trimoxazole / malondialdehyde / diene conjugates / catalase / lysozyme

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