title: Antimicrobial efficacy of oral topical agents on microorganisms associated with radiated head and neck cancer patients: an in vitro study.
abstract: OBJECTIVE
  A variety of oral topical agents have been used for prevention and management of radiotherapy-induced adverse effects. The antimicrobial nature of some of the commonly used agents is unknown. The purpose of this study was to evaluate antimicrobial efficacies of various oral topical agents on common microorganisms associated with radiated head and neck cancer patients.
  
  
  METHODS
  Seven commonly used topical oral agents-0.12% chlorhexidine with alcohol, 0.12% chlorhexidine without alcohol, baking soda-salt rinse, 0.4% stannous fluoride gel, 0.63% stannous fluoride rinse, calcium phosphate mouthrinse, and acemannan hydrogel (aloe vera) rinse-were evaluated in vitro for their antimicrobial efficacies against four common microorganisms. A combination of baking soda-salt rinse and 0.4% stannous fluoride gel was evaluated as the eighth agent. The microorganisms used were Staphylococcus aureus, group B Streptococcus, Escherichia coli, and Candida albicans. An ELISA reader was used to measure the turbidity of microbial culture wells and optical density (OD) values for each of the 960 wells recorded. Mean OD values were rank ordered based on their turbidity. One-way ANOVA with Tukey HSD post hoc analysis was used to study differences in OD values (P < .05).
  
  
  RESULTS
  Mean OD values classified for topical agents from lowest to highest were chlorhexidine with alcohol, chlorhexidine without alcohol, baking soda- salt, calcium phosphate rinse, and the combination of baking soda-salt and stannous fluoride gel. Mean OD values classified for microorganisms from lowest to highest were Escherichia coli, Staphylococcus aureus, group B Streptococcus, and Candida albicans.
  
  
  CONCLUSIONS
  A significant difference among the antimicrobial efficacies of topical agents was evident for each of four microorganisms (P < .05). There was also a significant difference among the antimicrobial efficacies of the same topical agent on the four microorganisms tested (P < .05).
authors.affiliation: Department of Prosthodontics, University of Texas Health Science Center, San Antonio, TX, USA. avinashbidra@yahoo.com
authors.forename: Avinash S
authors.initials: AS
authors.lastname: Bidra
authors.forename: Jeffery J
authors.initials: JJ
authors.lastname: Tarrand
authors.forename: Dianna B
authors.initials: DB
authors.lastname: Roberts
authors.forename: Kenneth V
authors.initials: KV
authors.lastname: Rolston
authors.forename: Mark S
authors.initials: MS
authors.lastname: Chambers
mesh_terms: D000284:Administration, Oral; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D001431:Bacteriological Techniques; D002130:Calcium Phosphates / Q000627:therapeutic use; D002176:Candida albicans / Q000187:drug effects; D002710:Chlorhexidine / Q000627:therapeutic use; D004926:Escherichia coli / Q000187:drug effects; D000431:Ethanol / Q000008:administration & dosage; D005782:Gels; D006258:Head and Neck Neoplasms / Q000382:microbiology / Q000532:radiotherapy*; D006801:Humans; D008351:Mannans / Q000627:therapeutic use; D009055:Mouth / Q000382:microbiology*; D009067:Mouthwashes / Q000008:administration & dosage / Q000627:therapeutic use*; D010936:Plant Extracts / Q000627:therapeutic use; D017693:Sodium Bicarbonate / Q000627:therapeutic use; D017673:Sodium Chloride, Dietary / Q000627:therapeutic use; D012997:Solvents / Q000008:administration & dosage; D013211:Staphylococcus aureus / Q000187:drug effects; D013292:Streptococcus agalactiae / Q000187:drug effects; D014002:Tin Fluorides / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000891:Anti-Infective Agents, Local; D002130:Calcium Phosphates; D005782:Gels; D008351:Mannans; D009067:Mouthwashes; D010936:Plant Extracts; D017673:Sodium Chloride, Dietary; D012997:Solvents; D014002:Tin Fluorides; D000431:Ethanol; D017693:Sodium Bicarbonate; C020243:calcium phosphate; D002710:Chlorhexidine; C058414:acemannan