Antibiotic therapy

In medicine, antibiotics are used to inhibit the growth of harmful microorganisms or to kill them completely. They are therefore an important means of combating life-threatening conditions. Antibiotics are also justified in periodontology, however. Because periodontitis is also an infectious disease that is caused by a specific group of different bacteria.

A pharmacist holds a pack of antibiotics infront of many other packs

Responsible use of antibiotics

Although in times of rising resistance to antibiotics it is important to use antibiotics in a cautious and rational manner, in periodontology the Winkelhoff cocktail (combining metronidazole and amoxicillin) is commonly used as an universal weapon. Although this combination therapy “wipes out” all periodontitis-associated bacteria, it often represents an overkill. Because both the spectrum of bacteria and the bacterial load can vary greatly between patients in periodontal disease, and single-agent therapy would often suffice in many cases. Only by determining the type and quantity of bacteria present is it therefore possible to select a suitable active substance in a targeted manner, forming the basis for responsible antibiotic use.

Antibiotic use

The German Society of Periodontology (DG PARO) has defined both the antibiotic active substances that should be used in periodontology and the indications in which the patient usually benefits from antibiotic therapy. However, the timing of adjunctive antibiotic therapy is also important for the success of periodontal therapy. In order to maximize medication efficacy, directly simultaneous periodontal pocket cleaning is crucial.

Topical or systemic antibiotic therapy

The way in which medication is administered may vary depending on the clinical presentation. In the presence of a generalized form of periodontitis, systemic antibiotic therapy is usually beneficial because the medicine is able to reach all oral niches via the bloodstream. But there are also cases in which topical application of the antibiotic is appropriate. This is the case if refractory residual pockets are present, for example.