title: Commercial mouthwashes are more effective than azole antifungals against Candida albicans biofilms in vitro.
abstract: OBJECTIVE
  The aim of this study was to evaluate and compare the activity of prescription and over-the-counter antimicrobial compounds against planktonic and biofilm forms of Candida albicans isolated from cases of oral candidiasis in vitro.
  
  
  METHODS
  The efficacy of azoles, polyenes, an echinocandin, and 4 over-the-counter mouthwashes were tested against C. albicans-derived planktonic and biofilm cells.
  
  
  RESULTS
  Planktonic cells were shown to be highly sensitive to all of the antifungal agents tested. Sessile cells were highly resistant to azoles (≥128 mg/L) but equally sensitive to caspofungin and short treatments with Corsodyl, Listerine, and Oraldene.
  
  
  CONCLUSIONS
  Although C. albicans is sensitive to azole antifungal agents in planktonic form, it is highly resistant within the biofilm. The good efficacy of the over-the-counter mouthwashes against candidal biofilms in vitro suggests that clinical trials should now be designed to establish their role in the clinical management of oral candidal infections.
authors.affiliation: Glasgow Dental School, School of Medicine, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom. gordon.ramage@glasgow.ac.uk
authors.forename: Gordon
authors.initials: G
authors.lastname: Ramage
authors.forename: Anto
authors.initials: A
authors.lastname: Jose
authors.forename: Brent
authors.initials: B
authors.lastname: Coco
authors.forename: Ranjith
authors.initials: R
authors.lastname: Rajendran
authors.forename: Riina
authors.initials: R
authors.lastname: Rautemaa
authors.forename: Colin
authors.initials: C
authors.lastname: Murray
authors.forename: David F
authors.initials: DF
authors.lastname: Lappin
authors.forename: Jeremy
authors.initials: J
authors.lastname: Bagg
mesh_terms: D000935:Antifungal Agents / Q000737:chemistry / Q000494:pharmacology*; D001393:Azoles / Q000494:pharmacology; D018441:Biofilms / Q000187:drug effects*; D002176:Candida albicans / Q000187:drug effects* / Q000378:metabolism; D016009:Chi-Square Distribution; D054714:Echinocandins / Q000494:pharmacology; D006801:Humans; D008826:Microbial Sensitivity Tests; D009067:Mouthwashes / Q000627:therapeutic use*; D004366:Nonprescription Drugs / Q000494:pharmacology*; D010933:Plankton / Q000187:drug effects; D011090:Polyenes / Q000494:pharmacology; D018709:Statistics, Nonparametric
chemical_list: D000935:Antifungal Agents; D001393:Azoles; D054714:Echinocandins; D009067:Mouthwashes; D004366:Nonprescription Drugs; D011090:Polyenes