Antifungal Properties of Zataria multiflora on Candida species: A Systematic Review

Comparing the effects of Mycozin and Clotrimazole 1% creams on vaginal candidiasis: a triple-blinded randomized controlled trial

Clotrimazole 1% and Mycozin vaginal cream have been reported to be effective in relieving the symptoms of vulvovaginitis caused by Candida. The resistance to azole compounds, and the side effects of chemical drugs have been reported following azole therapy. It was hypothesized that Mycozin is at least as effective as Clotrimazole in treating vaginal candidiasis. This equivalent, triple-blinded, randomized clinical trial was conducted on 126 patients who complained of vaginal itching referred to Al-Zahra Teaching Hospital, Tabriz, Iran between September 2023 and May 2024. Participants were divided into two groups, i.e., Mycozin (n = 64) and Clotrimazole 1% (n = 62), using the block randomization method. The patient's complaints, clinical signs, the pH and culture of the secretions was recorded before and after treatment. The patient's improvement, level of satisfaction, and side effects were recorded. The data were analyzed using Pearson chi-square test, ANCOVA, and Mann-Whitney U test. There was no statistically significant difference between the two groups regarding the mean pH (Adjusted mean difference: 0.01; 95% Confidence Interval (CI): -0.20 to 0.21, P = 0.965), and microscopic evaluation (Odds Ratio (OR): 0.61; 95% CI; 0.28 to 1.36, P = 0.230). After the treatment the frequency of itching in the Clotrimazole group (N = 13; 22.0%) was lower than that of the Mycozin group (N = 26; 43.3%) (OR: 0.37; 95% CI: 0.17 to 0.82; P = 0.013). There was no statistically significant difference in other symptoms and signs before and after the treatment (P > 0.05). Also, there was no statistically significant difference between the two groups in the level of satisfaction (P = 0.056) and patient improvement (P = 0.074). The side effects of treatment with Mycozin and Clotrimazole were observed in eleven and five patients, respectively. Considering the efficacy of Mycozin vaginal cream in eliminating most of the symptoms and signs associated with vaginal candidiasis and its positive effect in negating the results of culture, it can be used as a suitable alternative in the treatment of vaginal candidiasis in patients interested in herbal medicines and resistant to azole compounds.Trial registration: Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N77. Date of registration: 20/05/2023; URL: https://irct.behdasht.gov.ir/user/trial/68718/view ; Date of first registration: 31/05/2023.

Antimicrobial role of Lavandula angustifolia towards Candida albicans, Streptococcus mutans, Staphylococcus aureus and anti-adherence effect on denture base resin

Objectives

The objective of the study was to determine the antimicrobial efficacy of Lavandula angustifolia (True Lavender extract) towards Candida albicans, Streptococcus mutans, Staphylococcus aureus pathogens. Varying proportions of the extract was incorporated into polymethyl methacrylate (PMMA) denture base resin and the anti-adherent effect was investigated.

Methods

An in-vitro study was performed after pure extract was obtained from Lavandula angustifolia (LA) flowers using a solvent based hot extraction process. Chromatographic analysis and computational molecular docking were done to analyze its phytoconstituents with potential target-ligand bond. Tests of antimicrobial susceptibility, minimum inhibitory concentration, minimum bactericidal and fungicidal dosages and in-vitro cytotoxicity were performed. Different proportions of LA extract (0, .5, 1.0, 1.5, and 2.0 %) were added to PMMA resin to assess anti-adherence property. Obtained data were statistically analyzed with One-way ANOVA followed by Tukey post-hoc tests.

Results

The reports revealed significant antimicrobial susceptibility against the test pathogens compared to control drugs (P > 0.05). A minimum concentration of .02 mg of lavender extract inhibited microbial growth with low cytotoxicity (P < 0.05). The highest anti-adherent activity was observed in the .5 % LA-incorporated PMMA resin group (P = 0.0001).

Conclusions

Incorporating lavender extract into denture base resin demonstrated promising antimicrobial properties. This investigation encourages further research to understand its effects on mechanical and physical properties of reinforced dental resins.

Denture stomatitis: Treatment with antimicrobial drugs or antifungal gels? A systematic review of clinical trials

STATEMENT OF PROBLEM

Gel formulations containing antimicrobials are a potential alternative for the development of new medicines for the treatment of denture stomatitis (DS). However, whether they are more effective than antifungal drugs is unclear.

PURPOSE

The purpose of this systematic review was to identify whether gels formulated with antimicrobial substances are more effective and biocompatible for the treatment of DS than antifungal drugs.

MATERIAL AND METHODS

This systematic review was structured according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022379510). Searches were performed in the PubMed, Lilacs, Web of Science, Scopus, Embase, and Google Scholar databases in November 2022. Randomized and nonrandomized clinical trials comparing the efficacy of experimental gels and conventional antifungals in the treatment of DS were included.

RESULTS

Gels formulated with Zataria multiflora essential oil and clove and cinnamon extracts showed higher antimicrobial efficacy compared with miconazole and clotrimazole. Formulations containing Uncaria tomentosa, Punica granatum, and propolis extract showed similar efficacy to nystatin and miconazole. Two formulations containing P. granatum were less effective than nystatin and miconazole. Gels of Z. multiflora and miconazole induced adverse effects including burning, itching, nausea, and vomiting. The included studies did not evaluate the biocompatibility of the gels.

CONCLUSIONS

Gels formulated with natural antimicrobials such as Z. multiflora, U. tomentosa, P. granatum, propolis, and clove and cinnamon showed higher or similar antimicrobial efficacy to conventional antifungals in the treatment of DS. The biocompatibility of experimental gels based on natural agents should be evaluated.