Antibiotic periodontal application

PEG-based copolyesters possess the ability to serve as absorbable controlled release carriers for a whole host of bioactive agents. The ability to provide a means of local therapy with systemically toxic agents directly at the site of interest has heightened awareness of these PEG-based systems. In addition, since these copolymers are absorbable, they allow for local drug delivery without the inherent risks associated with permanent foreign bodies. Some applications of the PEG-based systems include, but are not limited to, antibiotic formulations for osteomyelitis, controlled release of vaccines, intra-vaginal delivery of misoprostol, periodontal application of antibiotics, and intraocular drug delivery. 

The broad antibacterial activity of rifaximin as well as its topical action make this antibiotic suitable for intrapocket administration in periodontal disease. As a matter of fact, local application of rifaximin compares well with tetracyclines and metronidazole in other extra-GI diseases, i.e. skin infections and BY, respectively (see above). On the other hand, rifampicin (rifampin), another rifamy-cin derivative, has been successfully used in the treatment... 

In a preliminary study [70], intrapocket administration of rifaximin in patients with periodontal disease was studied from both microbiological and clinical points of view. The activity of this antibiotic against the microorganisms isolated from periodontal pockets is shown in table 3. The high local concentration of rifaximin should likely exceed the observed MIC values. Indeed, its topical application was followed by a quick disappearance of anaerobic bacteria and a marked reduction of aerobic microorganisms. This was accompanied by a significant clinical improvement. 

In the present study, tetracycline was selected because of its wide application, both locally and systemically, in the treatment of periodontal diseases. Tetracycline has been shown to be effective against many of the common periodontopathic bacteria, in particular, against Prevotella intermedia and Porphyromonas gingivalis [204-206]. In the current study, two commercially available bacterial strains were selected to meet the preliminary goal of whether the activity of antibiotics can be preserved after incorporation into preparations (Table 11.3)... 

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