Clinical study of azithromycin against various infections in the fields of dentistry and oral surgery

Abstract

The possibility of applying azithromycin (AZM), a new macrolide oral antibiotic, in the fields of dentistry and oral surgery was examined clinically.
1) A clinical examination was performed by administering AZM at a dose of 250 or 500mg once a day for 3 days to 148 patients with infection in the fields of dentistry and oral surgery. The efficacy rate (scoring assessment) was 65.0%(13/20) during 250mg dosing and 90.7%(98/108) during 500mg dosing.
2) The efficacy rate in relation to individual diseases was 78.7%(37/47) for periodontitis, 90.0%(27/30) for pericoronitis and 92.2%(47/51) for osteitis of jaw.
3) The bacterial eradication rate (“disappeared” or “replacement of bacteria”) was 92.3%(60/65).
4) Skin rash was observed in 1 patient treated with 500mg of AZM and the overall incidence of adverse reactions was 0.7%(1/146). The incidence of abnormal laboratory values was 90%(12/134).
5) The safety rate (rate of “no problem”) was 91.1%(133/146).
6) The utility rate (rate of “more than useful”) was 82.2%(106/129).
7) Migration of AZM at a dose of 250 or 500mg into blood, oral tissues, or effusion standing in operative wound after oral surgical tooth extraction performed in 71 patients was investigated. The concentrations of AZM in the wound recorded during the period of 1.4 to 20.5hours after administration of 500mg single-dose AZM ranged from 0.01 to 0.95μg/ml. Oral tissue specimens were measured for AZM concentrations during the period of 3 to 28 hours after the administration, and the follwing results were obtained: 0.27 to 5.6μg/g in the gum, 0.57 to 14.1μg/g in the cystic wall tissue, and 0.06 to 2.50μg/g in other tissues such as tumor-laden oral tissue and maxilla.
The above results suggest that AZM is useful in the treatment of infections associated with dental and oral surgery.