Background: Common oral bacteria are involved in the etiology of odontostomatological infections and there is a prevalence of Gram negative anaerobic microorganisms that are increasingly often found to be resistant to common beta-lactamases. In the light of this phenomenon, the use of beta-lactamases has been replaced by macrolides. The development of azithromycin, which is active against anaerobes and characterised by a wider spectrum of action against Gram negative bacteria, has opened new horizons in the therapeutic approach to odontostomatological infections.
Aims: The aim of the study was to evaluate the clinical efficacy and the tolerability of azithromycin in odontostomatological infections. The study was performed using an open test method, without a comparative drug.
Methods: One hundred patients, including 51 males and 49 females aged between 18 and 64 years old, were included in the study. These patients showed clinical and radiographic symptoms of acute apical periodontitis, periodontal abscess, or third molar dysodontiasis. They were divided into three groups. The drug protocol used was 500 mg/day for three days. The efficacy of the antibiotic was assessed one week after the start of treatment by evaluating the evolution of the pathology on the basis of subjective symptoms (pain) and objective signs (reddening, swelling, basal temperature). A progressive system was used to quantify the clinical findings using an arbitrary score from 0 to 3. The tolerability of treatment was evaluated by recording any signs observed in the patients' data records.
Results: The initial mean score for painful symptoms passed from 2.88 to 0.34. The initial mean score for the reddening parameter also fell from 2.3 to 0.34. The same results were found for the reddening sign which presented a mean value of 2.1 at the start of treatment and 0.38 at the end. The 8 patients who presented fever also showed a remission. The overall incidence of side effects was 8%. The side effects affected the gastrointestinal tract.
Conclusions: From an analysis of these results it can be affirmed that azithromycin achieved good therapeutic results in odontostomatological infections in terms of both efficacy and tolerability.