Question

Azithromycin for drug-induced gingival hyperplasia

Answer 1

Gingival hyperplasia is the overgrowth of gingival (gum) tissue that surrounds the teeth. Gingival hyperplasia may be caused due to several factors like hereditary, drug induced or metabolic disorder.

Drug induced gingival hyperplasia can be caused due side effects of certain drugs like cyclosporin, calcium antagonist, phenytoin. These drugs cause damage to keratinocytes, fibroblasts and collagen resulting in overgrowth of the gingiva.

Drug induced gingival hyperplasia has been shown to improve by antibiotic treatment. Azithromycin is a macrolide antibiotic used to treat cyclosporin induced gingival hyperplasia. According to research the medicine works through 3 mechanism :

1. Antibiotic effect

2. Immunomodulating

3. Anti inflammatory

Cyclosporin disrupts the balance between collagen synthesis and breakdown. The blocking action of cyclosporin on calcium inhibits the enzyme collagenase responsible for breakdown of collagen. This impairs the collagen degradation and results in gingival overgrowth. Azithromycin counteracts the action of cyclosporin by restoring collagen phagocytosis. It also blocks cell proliferation and collagen synthesis induced cyclosporin. It also have anti inflammatory effect on the gingiva and restrict gram positive and negative anaerobes.