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Distribution of systemic clarithromycin to gingiva
Renita C Burrell1, John D Walters
1Section of Periodontology, College of Dentistry, The Ohio State University, 305 W. 12th Street, Columbus, OH 43210, USA.
Journal of Periodontology
|September 6, 2008
Summary
Clarithromycin concentrates in gingival tissue, reaching higher levels in inflamed areas than in serum. This antibiotic shows potential for treating periodontitis due to its favorable distribution and possible anti-inflammatory effects.
Area of Science:
- Periodontology
- Pharmacokinetics
- Microbiology
Background:
- Aggressive periodontitis is linked to Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis.
- Tissue-invading pathogens are challenging to eradicate with root planing alone.
- Systemic antibiotics improve periodontitis treatment outcomes but clarithromycin is underutilized.
Purpose of the Study:
- To evaluate clarithromycin's concentration in human gingival tissue.
- To compare drug levels in healthy versus inflamed gingival sites.
- To assess clarithromycin's potential utility in periodontitis treatment.
Main Methods:
- Experimental gingivitis was induced in eight healthy subjects.
- Clarithromycin (500 mg every 12 hours) was administered systemically.
- Gingival tissue and serum samples were collected for liquid chromatography analysis.
Main Results:
- Mean clarithromycin concentrations were significantly higher in gingiva (2.4-3.0 microg/g) than in serum (0.5 microg/ml).
- Gingival tissue levels were 5.7-fold higher in healthy sites and 7.0-fold higher in inflamed sites compared to serum.
- A significant reduction in gingival crevicular fluid flow was observed at control sites post-treatment.
Conclusions:
- Clarithromycin achieves higher concentrations in gingival tissue than in serum.
- Inflamed gingiva showed higher clarithromycin levels than healthy gingiva, suggesting suitability for periodontitis treatment.
- Observed reduction in crevicular fluid suggests potential anti-inflammatory properties of clarithromycin.
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