Perio

Question 0

What are the recommended antibiotic regimens, and indications for them, in treatment of periodontal disease?

Answer 0

They are recommended for aggressive perio (little plaque, deep pockets, often refractory—caused by Actinobacillus—15% of perio patients fall into this category)
Z-pack: Prescribe 1 day prior to first whole mouth PT—results comparable to Augmentin, but with improved sustained health 12 months later—even effective in patients with suppuration who have not had cleanings in years—10x higher concentration at inflammation (transported by neutrophils)
Augmentin—875mg bid for refractory patients—shown to reduce pockets >6mm

Question 1

How many US adults over age 30 currently have perio disease?

Answer 1

About 50%
9% mild, 9% severe, 30% moderate
(CDC 2010; http://jdr.sagepub.com/content/91/10/914)

Question 2

When is Arestin recommmended?

Answer 2

1-2 nonresponsive sites at maintenance or recall. Reinstrument before placement.

Question 3

What is the antibiotic recommendation if all other treatments have failed?

Answer 3

Augmentin 500mg + metronidazole 500mg q8h

Question 4

Antibiotics, diarrhea, C. dificile, and probiotics

Answer 4

Take probiotics twice daily concomitantly with antibiotic use and continue probiotics for 1 week after finishing antibiotic. Diarrhea incidence is reduced from 20%-40%, and colitis to almost zero. (EN)

Question 5

Antibiotics, diarrhea, C. dificile, and probiotics

Answer 5

Take probiotics twice daily concomitantly with antibiotic use and continue probiotics for 1 week after finishing antibiotic. Diarrhea incidence is reduced from 20%-40%, and colitis to almost zero. (EN)