Table 2 List of Systemic antibiotics used to treat periodontal patients

Amoxicillin + Metronidazole

Metronidazole: 250 mg

Amoxicillin: 500 mg for 2 years

Stage II

periodontitis

Antibiotic treatment decreased probing depth (PD) and gained clinical attachment

Five randomized clinical trials showed improvement in PD and bleeding on probing

One participant experienced nausea and vomiting and one developed candidiasis

Few participants observed light pain or a burning sensation following laser treatment. No side-effects were observed due to administration of antimicrobial agents

[178]

[179] [180,181,182,183,184]

Metronidazole: 500 mg

Amoxicillin: 375 mg for 6 months

Stage II periodontitis

Antibiotics reduced the count of sites containing PD as well as bleeding on probing. Antibiotics with SRP led to a decrease in the count of T. forsythia, F. nucleatum, and P. gingivalis

Majority of the side effects were related to gastrointestinal disturbances such as nausea, diarrhea, vomiting as well as stomach burning

[185, 186]

Metronidazole: 500 mg

Amoxicillin: 500 mg for the time period of 6 months

Stage III periodontitis

Treatment reduced the load of pathogens such as T. forsythia as well as T. denticola. It also decreased the number of PD sites

One patient reported mild intestinal disturbance and one experienced vertigo

[187]

Amoxicillin + Metronidazole + Doxycycline

Metronidazole: 250 mg

Amoxicillin: 250 mg

Doxycycline: 100 mg for 2 months

Stage III periodontitis

This drug treatment decreased the number of sites with PD

No side effects were reported related to the antibiotic administration

[188]

Amoxicillin

 + Clavulanic acid

875 mg each 3 months

Stage I periodontitis

No difference was observed in PD between the control and test groups

/

[189]

Doxycycline

 + Clindamycin

 + Metronidazole

Doxycycline: 200 mg

Metronidazole: 500 mg

Clindamycin: 150 mg for 2 years

Stage IV periodontitis

Treatment decreased PD, gained clinical attachment, and reduced the load of P. gingivalis and Actinobacillus

Actinomycetemcomitans

/

[190]

Azithromycin

500 mg for 6 months

Stage II periodontitis

It helped to lessen PD and BANA scores

/

[191]

500 mg for 6 months

Stage III periodontitis

No reduction in microbial load and PD was observed

Participants did not report any adverse effects from the use of antibiotic and placebo

[192]

500 mg for the time period of 1 year

Stage III periodontitis

Treatment regimen declined PD and periodontal pathogens significantly

Participants did not report any adverse effects from the use of antibiotic and placebo

[193]

500 mg once a day for 5 days

Stage III periodontitis

Administration of antibiotic failed to improve clinical parameters when compared to scaling and root planning (SRP) alone

One participant experienced nausea after taking antibiotic

[194] [195]

Metronidazole

400 mg thrice a day for 10 days

Moderate to severe periodontitis (Stage III or IV) with Type 2 Diabetes Mellitus

SRP alone improved the periodontitis and glycemic control significantly

/

[196]