Background : Cyclosporine is a very potent immunosuppressant drugs commonly used to avoid transplant rejection. However, the drug comes with an array of adverse effects, such as nephrotoxicity, hepatotoxicity, hypertension, and gingival overgrowth. The drug induced gingival enlargement seen as an adverse event can lead to tooth loosening and ultimately tooth loss due to poor oral hygiene maintenance. The usual protocol is to surgically removal the overgrown tissue. Herein we would like to highlight a unique mechanism of action of azithromycin which can medically reduce the gingival hyperplasia.

Methods : We would like to present a case series of patients undergoing transplantation procedures who had gingival enlargements. The transplantation would have taken place within a time frame of up to 1 year. After oral prophylaxis azithromycin was administered for 7 days and the patients were on follow up. Surgical intervention was not performed in any of the patients in the samples selected for the study.

Results : There was substantial reduction in the enlargement after azithromycin administration.It should be noted that the enlargement caused by the drugs are pseudo and has no relationship to the plague and oral hygiene index. The oral hygiene should be maintained by patients and followed up by dentist. Azithromycin can only aid in reducing the pseudo pockets and not the gingival disease per se. Hence it is imperative to prescribe chlorhexidine mouth wash as an adjunct to the medical treatment.

Conclusions : A medical treatment is usually an accepted treatment protocol for patient if they have a guaranteed success or has simulating results as that of a surgical modality. Hence It is trusted that this report will raise further familiarity with this non-interventional methodology in patients taking cyclosporine.