85789
document
Metronidazole in periodontitis ( IV ) . The effect of patient compliance on treatment parameters . Patient compliance with the unsupervised usage of prescription medication can be poor . In the treatment of periodontal infections with systemic antimicrobial agents , in situations where the efficacy of the antimicrobial agent is being evaluated , non-compliance could underestimate the true efficacy of the agent . Metronidazole is an agent with reported success in the treatment of anaerobic periodontal infections . Metronidazole is particularly effective in vitro against spirochetes , and this efficacy was investigated as a means of measuring patient compliance with metronidazole usage . Patients who had high proportions of spirochetes , i.e. , > 20 % , in plaques removed from diseased periodontal sites , were given metronidazole ( 500 mg bid ) under supervision . In all individuals who received the metronidazole , there was a significant and rapid decline and/or disappearance of spirochetes from the plaque during the time interval that metronidazole was detectable in the saliva . This observed decline in spirochetes was then used to determine which patients had been compliant in a double-blind clinical trial involving the unsupervised usage of metronidazole . Only 10 of 18 patients ( 56 % ) were considered compliant in their usage of metronidazole . These 10 patients experienced a significantly greater benefit from the metronidazole than did the 8 patients who were considered noncompliant , i.e. , a reduction of surgical needs of 8.3 teeth per compliant patient versus 3.6 teeth per non-compliant patient . A test for the hydrolysis of the synthetic peptide ( BANA ) was also able to identify most non-compliant patients . Clinical trials involving the unsupervised usage of systemic medication need to take into account patient non-compliance .
85790
Intervention_Pharmacological
Metronidazole
85791
Intervention_Pharmacological
periodontitis
85792
Intervention_Pharmacological
Metronidazole
85793
Intervention_Pharmacological
Metronidazole
85794
Intervention_Pharmacological
metronidazole
85795
Intervention_Pharmacological
metronidazole
85796
Intervention_Pharmacological
metronidazole
85797
Intervention_Pharmacological
metronidazole
85798
Intervention_Pharmacological
metronidazole
85799
Intervention_Pharmacological
metronidazole
85800
Intervention_Pharmacological
metronidazole
85801
Outcome_Physical
significant and rapid decline and/or disappearance of spirochetes from the plaque
85802
Outcome_Other
significantly greater benefit from the metronidazole
85803
Outcome_Other
reduction of surgical needs
85804
Participant_Condition
periodontal infections with systemic antimicrobial agents
85805
Participant_Condition
high proportions of spirochetes , i.e.
85806
Participant_Condition
> 20 % , in plaques removed from diseased periodontal sites
85807
Participant_Sample-size
18