Poređenje cefiksima i kombinacije amoksicilina sa metronidazolom u lečenju parodontopatije
Sažetak
Uvod/Cilj. I pored značajnog napretka u savremenoj medicini i poboljšanja opšteg zdravstvenog obrazovanja, parodontopatija je još uvek veoma rasprostranjena. Gubitak zuba je najteža komplikacija ovog oboljenja. Cilj našeg rada bio je da kod bolesnika sa parodontopatijom ispitamo efikasnost kauzalne terapije i kombinacije amoksicilina i metronidazola u poređenju sa cefiksimom, koji do sada nije primenjivan kod te kategorije bolesnika. Metode. Odrasli bolesnici sa hroničnom parodontopatijom (n = 90) prvo su podvrgnuti kauzalnoj terapiji (nulti dan), a zatim randomizacijom podeljeni u tri jednake grupe. Prva grupa bila je kontrolna, druga grupa dodatno je lečena kombinacijom amoksicilina i metronidazola (AMO-MET) tokom 7 dana, a treća grupa bolesnika cefiksimom, takođe, tokom 7 dana. Za procenu stanja parodoncijuma na početku lečenja i sedam dana kasnije, primenjena su četiri klinička parametra: gingivalni indeks (gingival index – GI), indeks krvarenja gingive (bleeding on probing – BOP), dubina parodontalnih džepova (probing depth – PD) i nivo pripojnog epitela (clinical attachment level – CAL). Rezultati. Sedmog dana od početka terapije ustanovljeno je da je kod sve tri grupe bolesnika došlo do statistički visokoznačajnog poboljšanja kliničkog stanja procenjenog parametrima GI, BOP i PD (p < 0,001), ali ne i parametrom CAL. Međutim, to poboljšanje PD kod sve tri grupe bolesnika bilo je samo od statističkog, ali ne i kliničkog značaja. Posle kauzalne terapije, poboljšanja GI i BOP sedmog dana u odnosu na nulti dan iznosila su 28% i 19%, a nakon primene AMO-MET 71% (BOP) i 77% (GI), odnosno 62% (BOP) i 82% (IG) posle primene cefiksima, što je bilo statistički visokoznačajno bolje u odnosu na kauzalnu terapiju (u oba slučaja p < 0,001). Poređeni međusobno, cefiksim je u odnosu na kombinaciju amoksicilina i metronidazola bio statistički značajno efikasniji za GI (p < 0,05). Zaključak. Dodatna primena amoksicilina u kombinaciji sa metronidazolom ili cefiksima kauzalnoj terapiji kod bolesnika sa parodontopatijom dovela je do statistički visokoznačajnog poboljšanja parametara GI i BOP, dok je cefiksim bio statistički značajno efikasniji od kombinacije amoksicilin-metronidazol u odnosu na parametar GI.
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