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Avaliação da resistência aos antibióticos em pacientes com periodontite: revisão integrativa
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Objetivo: Este trabalho tem como objetivo avaliar a resistência aos antibióticos em pacientes com periodontite, através de uma revisão integrativa da literatura. Pretende-se compreender o impacto do uso inadequado de antibióticos no tratamento periodontal e identificar estratégias terapêuticas alternativas baseadas em evidência.
Metodologia: Foi realizada uma pesquisa bibliográfica integrativa com base na seleção de 15 artigos científicos publicados entre 2013 e 2025, em bases de dados como PubMed e ScienceDirect. Foram aplicados critérios de inclusão e exclusão rigorosos, focando estudos sobre resistência antimicrobiana no contexto da periodontite.
Resultados: A análise evidenciou uma crescente prevalência de estirpes bacterianas resistentes a antibióticos entre pacientes com periodontite, especialmente em contextos onde os antibióticos foram utilizados de forma inadequada ou sem orientação microbiológica. Esta resistência esteve associada a falhas terapêuticas e à recorrência da doença. Além disso, a revisão destacou a ausência de protocolos clínicos padronizados e variações significativas nas práticas de prescrição. Foram identificadas várias estratégias alternativas promissoras como complemento ou substituto à terapêutica antibiótica convencional, incluindo a terapia fotodinâmica antimicrobiana, o uso de probióticos para restaurar o equilíbrio microbiano, a modulação da resposta do hospedeiro através de agentes anti-inflamatórios e da doxiciclina em dose subantimicrobiana, bem como tecnologias emergentes como a inteligência artificial, com potencial para personalizar e otimizar os cuidados periodontais.
Conclusão: A resistência antimicrobiana representa um desafio significativo e crescente para o tratamento eficaz das doenças periodontais. Esta realidade evidencia a necessidade urgente de adotar uma abordagem terapêutica mais individualizada e baseada em evidência científica. Os resultados sustentam a integração de estratégias alternativas não antibióticas nos protocolos clínicos, a promoção da formação profissional sobre o uso racional de antibióticos e a implementação de ferramentas diagnósticas que permitam adaptar o tratamento ao perfil de risco de cada paciente. Enfrentar a resistência antimicrobiana em periodontia requer um esforço multidisciplinar, combinando inovação clínica, conhecimento microbiológico e responsabilidade em saúde pública.
Objective: This study aims to evaluate antibiotic resistance in patients with periodontitis through an integrative literature review. It seeks to understand the impact of inappropriate antibiotic use in periodontal treatment and to identify evidence-based therapeutic alternatives. Methodology: An integrative literature review was conducted, selecting 15 scientific articles published between 2013 and 2025 from databases such as PubMed and ScienceDirect. Strict inclusion and exclusion criteria were applied, focusing on studies addressing antimicrobial resistance in the context of periodontitis. Result: The analysis revealed an increasing prevalence of antibiotic-resistant bacterial strains among patients with periodontitis, particularly in cases where antibiotics were used inappropriately or without microbiological guidance. This resistance was linked to treatment failures and disease recurrence. Moreover, the review highlighted a significant lack of standardized clinical protocols and variations in prescribing practices. Several alternative strategies were identified as promising complements or substitutes to conventional antibiotic therapy, including antimicrobial photodynamic therapy, the use of probiotics to restore microbial balance, host response modulation through anti-inflammatory agents and subantimicrobial doses of doxycycline, as well as emerging technologies like artificial intelligence and nanotechnology that may personalize and optimize periodontal care. Conclusion: Antimicrobial resistance poses a significant and evolving challenge to the effective management of periodontal diseases. This issue underscores the urgency of adopting a more evidence-based and individualized approach to therapy. The findings support the integration of alternative, non-antibiotic strategies into clinical protocols, the promotion of professional education on antimicrobial stewardship, and the implementation of diagnostic tools to tailor treatment to each patient’s risk profile. Ultimately, addressing antimicrobial resistance in periodontology requires a multidisciplinary effort combining clinical innovation, microbiological insight, and public health responsibility.
Objective: This study aims to evaluate antibiotic resistance in patients with periodontitis through an integrative literature review. It seeks to understand the impact of inappropriate antibiotic use in periodontal treatment and to identify evidence-based therapeutic alternatives. Methodology: An integrative literature review was conducted, selecting 15 scientific articles published between 2013 and 2025 from databases such as PubMed and ScienceDirect. Strict inclusion and exclusion criteria were applied, focusing on studies addressing antimicrobial resistance in the context of periodontitis. Result: The analysis revealed an increasing prevalence of antibiotic-resistant bacterial strains among patients with periodontitis, particularly in cases where antibiotics were used inappropriately or without microbiological guidance. This resistance was linked to treatment failures and disease recurrence. Moreover, the review highlighted a significant lack of standardized clinical protocols and variations in prescribing practices. Several alternative strategies were identified as promising complements or substitutes to conventional antibiotic therapy, including antimicrobial photodynamic therapy, the use of probiotics to restore microbial balance, host response modulation through anti-inflammatory agents and subantimicrobial doses of doxycycline, as well as emerging technologies like artificial intelligence and nanotechnology that may personalize and optimize periodontal care. Conclusion: Antimicrobial resistance poses a significant and evolving challenge to the effective management of periodontal diseases. This issue underscores the urgency of adopting a more evidence-based and individualized approach to therapy. The findings support the integration of alternative, non-antibiotic strategies into clinical protocols, the promotion of professional education on antimicrobial stewardship, and the implementation of diagnostic tools to tailor treatment to each patient’s risk profile. Ultimately, addressing antimicrobial resistance in periodontology requires a multidisciplinary effort combining clinical innovation, microbiological insight, and public health responsibility.
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Periodontite Resistência aos antibióticos Terapia periodontal Terapias alternativas Periodontitis Antibiotics resistance Periodontal therapy Alternative therapies