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Voice Prosthesis Coated with Sustained Release Varnish Containing Clotrimazole Shows Long-Term Protection against Candida albicans: An In Vitro Study |
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| Authors: | Ronit Vogt Sionov Irith Gati David Kirmayer Michael Friedman Doron Steinberg Menachem Gross |
| Institution: | 1.The Biofilm Research Laboratory, The Institute of Dental Sciences, The Faculty of Dental Medicine, The Hebrew University of Jerusalem, Jerusalem 9112102, Israel;2.Institute for Drug Research, School of Pharmacy, The Hebrew University of Jerusalem, Jerusalem 9112102, Israel; (I.G.); (D.K.); (M.F.);3.Department of Otolaryngology-Head and Neck Surgery, Hadassah Medical Center, Jerusalem 9112102, Israel;4.The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9112102, Israel |
| Abstract: | Fungal biofilm formation on voice prosthesis (VP) is a major health problem that requires repeated replacement of the prosthesis. Candida albicans is one of the pathogens that frequently inhabits the VP. We proposed that coating VPs with sustained-release varnish (SRV) containing clotrimazole (CTZ) might prevent fungal biofilm formation. The long-term antifungal activities of SRV-CTZ- versus SRV-placebo-coated VPs was tested daily by measuring the inhibition zone of C. albicans seeded on agar plates or by measuring the fungal viability of C. albicans in suspension. The extent of biofilm formation on coated VPs was analyzed by confocal microscopy and scanning electron microscopy. We observed that SRV-CTZ-coated VPs formed a significant bacterial inhibition zone around the VPs and prevented the growth of C. albicans in suspension during the entire testing period of 60 days. Fungal biofilms were formed on placebo-coated VPs, while no significant biofilms were observed on SRV-CTZ-coated VPs. HPLC analysis shows that CTZ is continuously released during the whole test period of 60 days at a concentration above the minimal fungistatic concentration. In conclusion, coating VPs with an SRV-CTZ film is a potential effective method for prevention of fungal infections and biofilm formation on VPs. |
| Keywords: | biofilm Candida albicans clotrimazole fungal infection laryngeal malignancies laryngectomy sustained release varnish (SRV) voice prosthesis |