Fungicidal amounts of antifungals are released from impregnated denture lining material for up to 28 days

摘要

Objectives: The aim of this study was to investigate the efficacy of a polymeric delivery system impregnated with chlorhexidine or fluconazole against Candida species. Methods: Self-cure poly-ethyl methacrylate and tetrahydro-furfuryl methacrylate (PEM/THFM) discs impregnated with pure fluconazole substance (FLUp), fluconazole powder from capsules (FLUc) or chlorhexidine powder (CHX) were incubated in water for up to 28 days at 37 °C. The water was replaced at 24 h and 3, 7, 14, 21, 28 days. The amount of released drugs and antifungal activity of the leachates was measured by bioassay. The minimal inhibitory concentration (MIC) of each drug for 46 Candida isolates was determined and compared to the released concentrations. Results: A total of 53.0% of CHX, 38.5% of FLUc and 13.2% of FLUp impregnated into the discs was leached during the 28-day incubation. Of the total amount leached, 71.8% of CHX, 75.1% of FLUc and 70.5% of FLUp was released during the first week of incubation. Antifungal activity was confirmed for up to 28 days. Conclusion: Both chlorhexidine and fluconazole become readily leached from PEM/THFM polymer up to four weeks and that the polymerisation of the acrylic does not affect the antimicrobial activity of the agents. Importantly, the amount of drugs released exceeded the MICs of most isolates also during the fourth week of incubation. Clinical significance: These findings indicate the feasibility of this treatment modality for oral candidal infections, especially denture stomatitis. But further in vivo work is warranted to determine its clinical relevance and applicability.