Page 10 - IDX-DecisionTree-Booklet-Digital

Step 3

Adjunctive Systemic Antimicrobials
(When indicated)

The following protocol applies to ImpetusDX Oral Health Panel
results showing detected levels of:

• Purple complex bacteria at any detected level when paired
with clinical inflammation
• Red complex bacteria at medium or high levels

• Orange complex bacteria at medium or high levels
• Green complex bacteria at high levels when paired with deep
pockets (≥6 mm), bleeding on probing (BOP), or refractory sites

• Amoxicillin 500 mg TID + Metronidazole 500 mg TID for 7 days
(if no contraindications). Evidence shows benefit in PD reduction
and CAL gain when adjunctive. PMC+1
• Alternative (e.g. penicillin allergy): Azithromycin 500 mg QD
for 3 days or doxycycline 100 mg BID for 14 days (literature
supports use though less robust). PubMed
• Adjunctive antiseptic or subgingival irrigation such as 0.12%
chlorhexidine, povidone-iodine, sodium hypochlorite, chlorine
dioxide, xylitol, or antimicrobial powders (glycine or erythritol)
twice daily for 2-4 weeks concurrently to reduce extra-
subgingival load. MDPI

Monitoring: always check for drug
contraindications/allergies, adjust for systemic
medications. Use antibiotic stewardship principles.