Systemic versus topical administration of antibiotics

It is not only the active substance that is important in antibiotic therapy but also the method of administration. In the case of generalized periodontitis, systemic administration is appropriate, whereas individual residual pockets, for example, can also be treated topically.

Systemic antibiotic therapy

An important benefit of systemic antibiotic administration lies in the fact that the active substance reaches all the periodontal pockets and other oral niches colonized by the bacteria. Systemic administration is therefore especially suitable for generalized periodontal diseases in which many or all teeth are affected. The disadvantages of systemic antibiotic administration include possible side effects, which can range from mild gastrointestinal symptoms to allergic reactions. The general contraindications for antibiotics and their interactions with other medication must always be borne in mind! Learn more about this in the overview of recommended active substances for periodontal therapy. The rise in antibiotic resistance and the spread of multidrug-resistant bacteria should also be minimized by controlled, diagnostically confirmed and rational use.

Topical antibiotic therapy

Compared with systemic products, topical antibiotics usually have fewer side effects and permit a compliance-independent dosage of the medication. It is also possible to achieve considerably higher active ingredient concentrations in the place where they are needed. The following are considered as disadvantages: considerably more cumbersome to administer, higher costs and poor efficacy against organisms located outside the sulcus. In practice, the use of topical antibiotics is therefore especially recommended for the treatment of isolated defects and refractory residual pockets following a positive bacterial analysis.

Example of a topical antibiotic: Ligosan® Slow Release (In some countries Ligosan® Slow Release is also registered and available as Adjusan®, Ligosan® or Ligoslo®. Manufacturer: Kulzer)

  • Topical antibiotic for the adjunctive treatment of chronic and aggressive periodontitis to supplement conventional, non-surgical standard treatment at pocket depths of > 5 mm
  • After a single application, 14% doxycycline is released continuously from a biodegradable hydrogel matrix over a minimum period of 12 days
  • Covers the relevant periodontopathogenic bacteria with additional anti-inflammatory activity