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However, some sites\/patients do not respond adequately, and its limitations and shortcomings have been recognized. This has led to the development of alternative or adjunctive therapies. One is the use of antimicrobials to target bacteria in subgingival biofilms in the periodontal pocket, which can be targeted directly through the pocket entrance with a locally delivered antibiotic or systemically by oral, intravenous, or intramuscular methods. Since the early 20th century, several studies on systemic antibiotics have been undertaken and published, especially between 1990 and 2010. Europe's latest contribution to this topic is the first European Federation of Periodontology, S3\u2010level Clinical Practice Guideline, which incorporates recommendations related to the use of adjuncts to treat stage I\u2010III periodontitis. Understanding the etiopathogenesis of periodontal diseases, specifically periodontitis, has influenced the use of systemic periodontal antibiotic therapy. Randomized clinical trials and systematic reviews with meta\u2010analyses have demonstrated the clinical advantages of adjunctive systemic antimicrobials. However, current recommendations are restrictive due to concerns about antibiotic misuse and the increase in microbial antibiotic resistance. European researchers have contributed to the use of systemic antimicrobials in the treatment of periodontitis through clinical trials and by providing rational guidelines. Nowadays, European researchers are exploring alternatives and directing clinical practice by providing evidence\u2010based guidelines to limit the use of systemic antimicrobials.<\/jats:p>","DOI":"10.1111\/prd.12492","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T11:22:01Z","timestamp":1686741721000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Europe's contribution to the evaluation of the use of systemic antimicrobials in the treatment of periodontitis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5554-2777","authenticated-orcid":false,"given":"David","family":"Herrera","sequence":"first","affiliation":[{"name":"ETEP (Etiology and Therapy of Periodontal and Peri\u2010Implant Diseases) Research Group University Complutense Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arie Jan","family":"van Winkelhoff","sequence":"additional","affiliation":[{"name":"Center for Dentistry and Oral Hygiene University of Groningen, University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Matesanz","sequence":"additional","affiliation":[{"name":"ETEP (Etiology and Therapy of Periodontal and Peri\u2010Implant Diseases) Research Group University Complutense Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katalina","family":"Lauwens","sequence":"additional","affiliation":[{"name":"Department of Oral Health Sciences, KU Leuven &amp; 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