Data sources The following electronic databases were searched with no language restrictions: MEDLINE, EMBASE and Cochrane library. Reference lists of included studies were searched, alongside the Open Grey database and hand searches in Journal of Dental Research, Journal of Periodontology, Journal of Clinical Periodontology and Journal of Periodontal Research. The editor of each journal was contacted to enquire about relevant accepted and forthcoming articles.Study selection Two independent reviewers screened for randomised controlled trials (RCTs) with a follow-up of at least six months. The main outcome was the change in periodontal pocket depths (PPD) and clinical attachment level (CAL) six months after treatment, where patients were divided according to adjunctive treatment (antimicrobial vs placebo) as well as the pre-treatment detection of periodontopathogenic bacteria.Data extraction and synthesis Data was extracted from all selected papers using a standardised form, including treatment methods, antimicrobial regime and bacterial detection methods. The Cochrane Collaborations tool was used to assess risk of bias. The weighted mean difference (WMD) of treatment effects between bacterial detection groups was obtained and pooled. A two-stage, fixed-effects meta-analysis was performed, and statistical heterogeneity was described using the Q-statistic and I2 index.Results Following the screening of 643 papers and author contact, five placebo-controlled studies were included in the systematic review. All had a low risk of bias. They varied in patient sample sizes, periodontal diagnoses, subgingival debridement protocols, antimicrobial regimes, as well as baseline microbial analysis methods. The meta-analysis of four studies, using amoxicillin and metronidazole as adjuncts, revealed a significant increase in the reduction of PPDs compared to placebo. It also showed no significant difference in the clinical effect on PPDs ≥5 mm when prescribing adjunctive amoxicillin and metronidazole based on the pre-treatment detection of A. actinomycetemcomitans (WMD = 1.16, 95% CI [-5.37, 7.68], I2 = 37.8%).Conclusions Although data on baseline periodontopathogenic bacteria was limited to A. actinomycetemcomitans, this systematic review suggests that there is not enough evidence to support the use of pre-treatment analysis of subgingival bacteria as a criterion for prescribing adjunctive antibiotics.

中文翻译：

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对于牙周病原菌，辅助性抗生素与非手术牙周治疗的临床益处？

数据源不受语言限制地搜索了以下电子数据库：MEDLINE，EMBASE和Cochrane库。搜索了纳入研究的参考文献清单，并在“牙科研究杂志”，“牙周病杂志”，“临床牙周病杂志”和“牙周研究杂志”上搜索了开放灰色数据库并进行了人工搜索。研究选择了两名独立的审阅者，进行了至少六个月的随访，以筛选随机对照试验（RCT）。主要结局是治疗六个月后牙周袋深度（PPD）和临床附着水平（CAL）的变化，根据辅助治疗（抗菌药物与安慰剂）以及牙周病原菌的治疗前检测对患者进行分类数据提取和综合数据以标准化的形式从所有入选论文中提取，包括治疗方法，抗菌方案和细菌检测方法。使用Cochrane合作工具评估偏倚风险。获得并合并细菌检测组之间的治疗效果的加权平均差（WMD）。进行了两阶段的固定效应荟萃分析，并使用Q统计量和I2指数描述了统计异质性。结果筛选了643篇论文并与作者联系后，系统评价中纳入了五项安慰剂对照研究。所有人的偏见风险都很低。它们在患者样本量，牙周诊断，龈下清创方案，抗菌方案以及基线微生物分析方法方面各不相同。使用阿莫西林和甲硝唑作为辅助剂的四项研究的荟萃分析显示，与安慰剂相比，PPD的降低显着增加。根据前放线放线杆菌的检测，在处方辅助性阿莫西林和甲硝唑时，对≥5mm PPD的临床疗效也无显着差异（WMD = 1.16，95％CI [-5.37，7.68]，I2 = 37.8）结论）尽管基线牙周病原菌的数据仅限于放线放线杆菌（A. actinomycetemcomitans），