The effects of sustained release doxycycline on the anaerobic flora and antibiotic-resistant patterns in subgingival plaque and saliva.

ABSTRACT

BACKGROUND: The purpose of this study was to determine the effects of periodontal treatment with a sustained-release, biodegradable gel containing 8.5% doxycycline on the anaerobic flora and on antibiotic susceptibility patterns associated with subgingival plaque and saliva. METHODS: Forty-five subjects with adult periodontitis were entered into a parallel design, single-blind study of 6 months' duration. The subjects were randomized to receive either doxycycline treatment (n = 23) or oral hygiene instruction/reinforcement (n = 22). Saliva and subgingival plaque samples were collected prior to and at 7, 21, 91, and 182 days after initiation of treatment. The proportion of the cultivable flora resistant to 10 microg doxycycline/ml was determined relative to total anaerobic counts, and the 3 most predominant colony types resistant to doxycycline were individually enumerated. A representative of each was subcultured, identified to genus and species level, and tested for its susceptibilities to 6 antibiotics. RESULTS: A significant decrease (P <0.01) in total anaerobic counts following doxycycline treatment caused a transient increase in the proportion, but not in the actual counts, of doxycycline-resistant bacteria recovered from both plaque and saliva at 7 and 21 days but not at 91 or 182 days. The same doxycycline-resistant taxa were recovered at all sample periods including baseline. Regardless of treatment, the isolates were similarly distributed and belonged to the same bacterial groups. CONCLUSIONS: Doxycycline treatment significantly reduced the anaerobic population in plaque but did not result in a change in either the number of resistant bacteria present or the acquisition of antibiotic resistance.