In the beginning

Azithromycin is an antibiotic that is closely related to erythromycin.  It was first formulated in 1980 but did not become available in Australia until 2004.  The properties of azithromycin are documented here.  In addition to being an effective antibiotic against a wide variety of bacteria (including Gram -ve periodontal pathogens), azithromycin has significant immuno-modulatory/ anti-inflammatory activity which is applied in the treatment of diseases that are not caused by bacteria, such as cystic fibrosis and asthma.  Azithromycin's anti-inflammatory properties make it a potentially useful agent in the management of inflammatory periodontal diseases as we move into the age of 'host modulation' in the treatment of these diseases.

The periodontal responses that will be documented in this blog have occurred following the prescription of a single course of azithromycin which is:  one 500mg tablet taken a day for 3 days, 2 hours after a meal.  The generic version in Australia is Zedd 500.  Azithromycin must not be prescribed to people with known allergy to erythromycin; 95% of patients do not report side effects.  Compliance is high because only 3 tablets are in the course and side effects are infrequent.

I intend to post clinical cases which highlight the periodontal responses to azithromycin as an adjunct to minimal periodontal intervention (usually oral hygiene instruction and subgingival debridement).  I will share the protocol I use to decide on case selection and timing of periodontal treatment after the patient takes the azithromycin.

Your constructive comments and queries are welcomed and I encourage you to post your own cases if you have clinical photographs or sequential radiographs, or simply descriptions of how your patients' periodontal condition changed over time, including what the patients report to you.