Antifungal Efficacy of Triple Antibiotic Paste, Double Antibiotic Paste with Fungicide and Calcium Hydroxide with Chitosan as a Vehicle against Candida albicans: An In vitro Study

Introduction: The purpose of current research is to assess the in vitro antimicrobial efficacy of different medicaments with two different vehicles against Candida albicans (C. albicans). Materials and Methodology: An agar well diffusion assay was used to determine the experimental medicaments' efficacy against C. albicans. Medicaments were divided into six groups, which includes Triple antibiotic powder (TAP) with saline or chitosan, Double antibiotic powder with fungicide (DAPF) with saline or Chitosan, and calcium hydroxide with saline or Chitosan. The diameters of growth inhibition zones were recorded and compared for each group for three days, i.e., 1,4,7 days. The differences between groups were analyzed by Kruskal-Wallis and Mann-Whitney U tests. Results: The largest inhibition zones were observed for the double antibiotic paste + fungicide with chitosan and the smallest for Ca(OH)2 with saline. Over a week, zones of inhibition were consistent only with group V – double antibiotic paste with fungicide and chitosan as the vehicle. Conclusion: DAPF with chitosan is more efficient against Candida albicans. Since the endodontic infections are polymicrobial in origin, the combined local drug delivery of antimicrobial agents such as ciprofloxacin, metronidazole, doxycycline along with antifungal drugs such as fluconazole with an efficient drug carrier (chitosan) is recommended to combat the microbial load.

Negative pressure wound therapy does not diminish efficacy of topical antibiotic powder in a preclinical contaminated wound model

Aims High-energy injuries can result in multiple complications, the most prevalent being infection. Vancomycin powder has been used with increasing frequency in orthopaedic trauma given its success in reducing infection following spine surgery. Additionally, large, traumatic injuries require wound coverage and management by dressings such as negative pressure wound therapy (NPWT). NPWT has been shown to decrease the ability of antibiotic cement beads to reduce infection, but its effect on antibiotic powder is not known. The goal of this study was to determine if NPWT reduces the efficacy of topically applied antibiotic powder. Methods Complex musculoskeletal wounds were created in goats and inoculated with a strain of Staphylococcus aureus modified to emit light. Six hours after contaminating the wounds, imaging, irrigation, and debridement and treatment application were performed. Animals received either vancomycin powder with a wound pouch dressing or vancomycin powder with NPWT. Results There were no differences in eradication of bacteria when vancomycin powder was used in combination with NPWT (4.5% of baseline) compared to vancomycin powder with a wound pouch dressing (1.7% of baseline) (p = 0.986), even though approximately 50% of the vancomycin was recovered in the NPWT exudate canister. Conclusion The antimicrobial efficacy of the vancomycin powder was not diminished by the application of NPWT. These topical and locally applied therapies are potentially effective tools that can provide quick, simple treatments to prevent infection while providing coverage. By reducing the occurrence of infection, the recovery is shortened, leading to an overall improvement in quality of life. Cite this article: Bone Joint Res 2021;10(2):149–155.

Comparative Antimicrobiotic Efficacy Test of Triple Antibiotic Paste, Double Antibiotic Paste with Fungicide and Calcium Hydroxide with Chitosan as Vehicle against Enterococcus faecalis: An In vitro Study

Introduction: This present research aimed to assess the in vitro antimicrobial efficacy of triple antibiotic paste and calcium hydroxide with two different vehicles against Enterococcus faecalis (E. faecalis). Materials and Methodology: An agar well diffusion assay was used to determine the experimental medicaments' efficacy against E. faecalis. Medicaments were divided into six groups, which includes Triple antibiotic powder (TAP) with saline or chitosan, Double antibiotic powder with fungicide (DAP 1) with saline or Chitosan, and calcium hydroxide with saline or Chitosan. These medicines were tested in an agar well diffusion test for three days, i.e., 1,4,7 days. The diameters of growth inhibition zones were recorded and compared for each group were tested in an agar well diffusion test for three days, i.e., 1,4,7 days. The diameters of growth inhibition zones were recorded and compared for each group. These medicaments were evaluated for three days an agar well diffusion test, i.e., on 1,4,7 days. The inhibition zones diameters for each group were recorded and compared — the differences between groups analyzed by Kruskal-Wallis and Mann-Whitney U tests. Results: The largest inhibition zones were observed for the triple antibiotic powder with chitosan and the smallest for Ca(OH)2 with saline. As days progress, they produced lesser antibacterial effects in all groups. Conclusion: Triple antibiotic paste and Chitosan were more effective in eliminating microorganisms than calcium hydroxide and DAP 1.