The advantages of systemic antibiotics include the ability for the drug to control pathogens in all periodontal tissues and other sites where they may have an impact. They may help to reduce future colonization. Another advantage may be a relatively low financial cost to the patient. However, systemic antibiotics may not reach the concentrations in the periodontal pocket needed to do the job, may be involved in drug side effects and interactions, may be subject to compliance issues and have been known to select and favor the growth of organisms that are not susceptible to the agent. Systemic antibiotics are not routinely used in chronic periodontitis due to increased concern about the induction of resistant organisms. They may be utilized in appropriately selected patients, such as refractory cases, along with other plaque control strategies.17
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