Evidence map›Paper›PMID 42654121›Full record

ReviewPharmaceutics2026

Azithromycin in Dentistry: From Systemic Antibiotic to a Candidate for Local Therapeutic Delivery.

Jakub Kwiatek, Magdalena Paczkowska-Walendowska, Judyta Cielecka-Piontek

Abstract readReview
In one paragraph

Review in Pharmaceutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Jakub KwiatekKwiatek Dental Clinic Sp. z o.o., Kordeckiego 22, 60-144 Poznan, Poland.ORCID 0009-0007-7712-4000
Magdalena Paczkowska-WalendowskaDepartment of Pharmacognosy and Biomaterials, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland.ORCID 0000-0002-0418-9336
Judyta Cielecka-PiontekDepartment of Pharmacognosy and Biomaterials, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznan, Poland.ORCID 0000-0003-0891-5419

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Azithromycin is widely used in dentistry as a systemic antibiotic, particularly for odontogenic infections and as an alternative in patients with β-lactam hypersensitivity. Beyond its antimicrobial activity, azithromycin possesses unique pharmacokinetic, anti-inflammatory, immunomodulatory, and anti-biofilm properties. Together with growing concerns regarding antimicrobial resistance and antibiotic stewardship, these characteristics have stimulated interest in local drug-delivery strategies that may reduce systemic antibiotic exposure while maintaining therapeutic efficacy. This narrative review evaluates the rationale, potential clinical applications, and current evidence supporting local azithromycin delivery in dentistry. The available literature on azithromycin pharmacology, systemic dental use, immunomodulatory mechanisms, biofilm-related effects, local drug-delivery systems, safety, and regulatory considerations was critically reviewed. Current evidence suggests that locally delivered azithromycin may achieve high drug concentrations at the target site, enhance anti-biofilm activity, modulate local inflammation, and minimize systemic exposure. Potential applications include periodontitis, peri-implant diseases, persistent endodontic infections, oral surgery, and regenerative procedures such as bone augmentation and maxillary sinus floor elevation. Emerging delivery platforms, such as hydrogels, thermoresponsive gels, nanoparticles, and chitosan-based systems, further support the feasibility of this approach. Experimental findings also indicate that azithromycin may inhibit osteoclast activity, suggesting additional benefits for bone preservation and regenerative healing. Despite these promising findings, current evidence remains limited and is derived mainly from preclinical studies and small clinical investigations. Further translational research and well-designed randomized controlled trials are needed to establish the safety, efficacy, and optimal clinical role of locally delivered azithromycin in evidence-based dental practice.

Indexed as

azithromycinbiofilmdentistrylocal drug deliveryperiodontitisregenerative dentistry

Identifiers

PMID42654121
PMCPMC13516289

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.