Infecções periapicais agudas com envolvimento sistêmico – preparo químico-cirúrgico de canais radiculares associado ao uso sistêmico da azitromicina (avaliação clínica, microbiológica e tolerabilidade)

Resumo (EN)

Introduction – The objective of this study was to determine the clinical and microbiological efficacy and tolerability of a single daily dose of 500 mg azithromycin for 3 days (Zitromax® – Pfizer) in 38 patients presenting with acute periapical infection at the Section of Urgencies at School of Dentistry, University of São Paulo. Material and Methods – Signs and symptoms of infection, as well as microbiological examinations were assessed before administration of azithromycin at the 1st appointment (resumed chemical-surgical instrumentation and intra root medication), between 3rd and 5th days, on a 2nd appointment (complete chemical-surgical instrumentation and intra root medication), and between 8th and 12th days, on a 3rd appointment (root canal filling). Collections for microbiological tests were submitted to sodium tioglycolate culture, to a first bacterioscopy, followed by a 5% ram-blood Agar culture and finally to a second bacterioscopy. Results – Total healing of signs and symptoms of infection occurred in 93% of all patients, partial healing was verified in 5%, and infection remained in 2%. From the 9 patients submitted to microbiological examination, 67% showed complete eradication of microorganisms at the 2nd appointment, 22% on the 3rd appointment, and 11% persisted with presence of Streptococcus mitis. Adverse reactions resulting from azithromycin intake were abdominal pain in 16%, and tachycardia in 5% and diarrhea in 5% of all patients, all of which were of low to moderate intensity and did not require therapy interruption. Conclusion – The associated local therapeutical project to the sistemic use of azithromycin is efficient and of good tolerance in the treatment of acute periapical infections with therapy with indicated antibiotic, and therefore azithromycin is a good alternative for allergic patients to penicillins.