Metronidazole and Amoxicillin for the Treatment of Type 2 Diabetic Subjects With Periodontitis

NCT ID: NCT02135952

Last Updated: 2014-05-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

58 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-09-30

Study Completion Date

2014-10-31

Brief Summary

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Diabetes mellitus (DM) is a widely prevalent disease associated with several major systemic and oral complications, such as periodontitis. The use of adjunctive local and/or systemic antimicrobials has been proposed to improve the clinical and glycemic outcomes of the scaling and root planing (SRP) in diabetic subjects. The combination of metronidazole (MTZ) and amoxicillin (AMX) has been largely recognized as an effective therapy for improving the clinical and microbiological outcomes of SRP in the treatment of with chronic periodontitis (ChP). However, no previous clinical trials to date have evaluated the effects of this antibiotic combination in the treatment of diabetic subjects with periodontitis. Therefore, the aim of this randomized clinical trial (RCT) will be to evaluate the clinical and microbiological effects of the use of MTZ+AMX as adjuncts to SRP for the treatment of type 2 diabetic subjects with generalized ChP.

Detailed Description

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Conditions

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Periodontitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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SRP+MTZ+AMX

Scaling and root planing (SRP) + metronidazole (MTZ; 400 mg thrice a day \[TID\] for 14 days) + amoxicillin (AMX; 500 mg TID for 14 days)

Group Type ACTIVE_COMPARATOR

SRP

Intervention Type PROCEDURE

SRP in four to six appointments lasting approximately 1 h each, using manual curettes and ultrasonic device under local anesthesia.

MTZ+AMX

Intervention Type DRUG

Administration of antibiotics (metronidazole and amoxicillin) for 14 days started immediately after the first session of SRP.

SRP+placebo

Scaling and root planing + placebo

Group Type PLACEBO_COMPARATOR

SRP

Intervention Type PROCEDURE

SRP in four to six appointments lasting approximately 1 h each, using manual curettes and ultrasonic device under local anesthesia.

Placebo

Intervention Type OTHER

Administration of placebo for 14 days started immediately after the first session of SRP.

Interventions

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SRP

SRP in four to six appointments lasting approximately 1 h each, using manual curettes and ultrasonic device under local anesthesia.

Intervention Type PROCEDURE

Placebo

Administration of placebo for 14 days started immediately after the first session of SRP.

Intervention Type OTHER

MTZ+AMX

Administration of antibiotics (metronidazole and amoxicillin) for 14 days started immediately after the first session of SRP.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* ≥ 35 years of age
* Diagnosis of type 2 DM for ≥ 5 years
* DM treatment with diet and insulin supplementation or oral hypoglycemic agents
* Glycated hemoglobin (HbA1c) levels ≥ 6.5% ≤ 11%
* At least 15 teeth
* More than 30% of the sites with probing depth (PD) and clinical attachment level (CAL) ≥ 4 mm
* Minimum of six teeth with at least one site with PD and CAL ≥ 5 mm and bleeding on probing (BoP) at baseline.

Exclusion Criteria

* Pregnancy
* Lactation
* Current smoking
* Smoking within the past 5 years
* Scaling and root planing (SRP) in the previous 12 months
* Antimicrobial therapies during the previous 6 months
* Medical conditions requiring prophylactic antibiotic coverage
* Continuous use of mouthrinses containing antimicrobials in the preceding 3 months
* Systemic conditions (except DM) that could affect the progression of periodontitis (e.g. immunological disorders, osteoporosis)
* Long-term administration of anti-inflammatory
* Long-term administration of immunosuppressive medications
* Allergy to metronidazole and/or amoxicillin
* Presence of periapical pathology
* Use of orthodontic appliances
* Presence of extensive prosthetic rehabilitation
* Major complications of DM (i.e. cardiovascular and peripheral vascular diseases \[ulcers, gangrene and amputation\], neuropathy and nephropathy)
Minimum Eligible Age

35 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Guarulhos

OTHER

Sponsor Role lead

Responsible Party

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Poliana Mendes Duarte

PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Poliana M Duarte, PhG

Role: PRINCIPAL_INVESTIGATOR

University of Guarulhos

Locations

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University of Guarulhos

Guarulhos, São Paulo, Brazil

Site Status

Countries

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Brazil

References

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Amid R, Tabeie MB, Kadkhodazadeh M, Mehdizadeh AR, Youssefi N. Local concentration of systemic amoxicillin and metronidazole in healthy and inflamed gingiva: a comparative in vivo study. Drug Metabol Drug Interact. 2012 May 10;27(2):113-8. doi: 10.1515/dmdi-2012-0003.

Reference Type BACKGROUND
PMID: 22706234 (View on PubMed)

Borgnakke WS, Ylostalo PV, Taylor GW, Genco RJ. Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. J Clin Periodontol. 2013 Apr;40 Suppl 14:S135-52. doi: 10.1111/jcpe.12080.

Reference Type BACKGROUND
PMID: 23627324 (View on PubMed)

Cionca N, Giannopoulou C, Ugolotti G, Mombelli A. Amoxicillin and metronidazole as an adjunct to full-mouth scaling and root planing of chronic periodontitis. J Periodontol. 2009 Mar;80(3):364-71. doi: 10.1902/jop.2009.080540.

Reference Type BACKGROUND
PMID: 19254119 (View on PubMed)

Cionca N, Giannopoulou C, Ugolotti G, Mombelli A. Microbiologic testing and outcomes of full-mouth scaling and root planing with or without amoxicillin/metronidazole in chronic periodontitis. J Periodontol. 2010 Jan;81(1):15-23. doi: 10.1902/jop.2009.090390.

Reference Type BACKGROUND
PMID: 20059413 (View on PubMed)

Feres M. Antibiotics in the treatment of periodontal diseases: microbiological basis and clinical applications. Ann R Australas Coll Dent Surg. 2008 Jun;19:37-44.

Reference Type BACKGROUND
PMID: 19728628 (View on PubMed)

Feres M, Soares GM, Mendes JA, Silva MP, Faveri M, Teles R, Socransky SS, Figueiredo LC. Metronidazole alone or with amoxicillin as adjuncts to non-surgical treatment of chronic periodontitis: a 1-year double-blinded, placebo-controlled, randomized clinical trial. J Clin Periodontol. 2012 Dec;39(12):1149-58. doi: 10.1111/jcpe.12004. Epub 2012 Sep 27.

Reference Type BACKGROUND
PMID: 23016867 (View on PubMed)

Grossi SG, Skrepcinski FB, DeCaro T, Robertson DC, Ho AW, Dunford RG, Genco RJ. Treatment of periodontal disease in diabetics reduces glycated hemoglobin. J Periodontol. 1997 Aug;68(8):713-9. doi: 10.1902/jop.1997.68.8.713.

Reference Type BACKGROUND
PMID: 9287060 (View on PubMed)

Jimenez M, Hu FB, Marino M, Li Y, Joshipura KJ. Type 2 diabetes mellitus and 20 year incidence of periodontitis and tooth loss. Diabetes Res Clin Pract. 2012 Dec;98(3):494-500. doi: 10.1016/j.diabres.2012.09.039. Epub 2012 Oct 3.

Reference Type BACKGROUND
PMID: 23040240 (View on PubMed)

Lang NP, Tonetti MS. Periodontal risk assessment (PRA) for patients in supportive periodontal therapy (SPT). Oral Health Prev Dent. 2003;1(1):7-16.

Reference Type BACKGROUND
PMID: 15643744 (View on PubMed)

Silva MP, Feres M, Sirotto TA, Soares GM, Mendes JA, Faveri M, Figueiredo LC. Clinical and microbiological benefits of metronidazole alone or with amoxicillin as adjuncts in the treatment of chronic periodontitis: a randomized placebo-controlled clinical trial. J Clin Periodontol. 2011 Sep;38(9):828-37. doi: 10.1111/j.1600-051X.2011.01763.x. Epub 2011 Jul 15.

Reference Type BACKGROUND
PMID: 21762197 (View on PubMed)

Zandbergen D, Slot DE, Cobb CM, Van der Weijden FA. The clinical effect of scaling and root planing and the concomitant administration of systemic amoxicillin and metronidazole: a systematic review. J Periodontol. 2013 Mar;84(3):332-51. doi: 10.1902/jop.2012.120040. Epub 2012 May 21.

Reference Type BACKGROUND
PMID: 22612369 (View on PubMed)

Tamashiro NS, Duarte PM, Miranda TS, Maciel SS, Figueiredo LC, Faveri M, Feres M. Amoxicillin Plus Metronidazole Therapy for Patients with Periodontitis and Type 2 Diabetes: A 2-year Randomized Controlled Trial. J Dent Res. 2016 Jul;95(7):829-36. doi: 10.1177/0022034516639274. Epub 2016 Mar 24.

Reference Type DERIVED
PMID: 27013640 (View on PubMed)

Other Identifiers

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2013/01072-5

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

SISNEP/697

Identifier Type: -

Identifier Source: org_study_id

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