ANTISEPTIC EFFECT OF AN ALCOHOL-FREE CHITOSAN-CURCUMIN MOUTHWASH: A PROPHYLACTIC ALTERNATIVE IN CANCER AND IMMUNOCOMPROMISED PATIENTS

A non-staining, non-irritant (alcohol free) curcumin mouthwash was developed in order to be used for prevention the oral cavity infections in cancer and immunocompromised patients. Physiologically compatible formulation was formulated with acceptable solubility, stability as well as safety of curcumin (0.1% w/v) and chitosan (0.5% w/v) using polyethylene glycol (PEG) 400 as a solvent [1]. Antimicrobial activity of the developed chitosan-curcumin mouthwash against planktonic organisms and candida was evaluated and compared with that of standard 2% w/v chlorhexidine mouthwash. Curcumin powder (with no volatile oil content) was active against all free floating test organisms with the highest antiseptic efficacy against C. albicans (MIC = 16 µg/mL) and the lowest antiseptic efficacy against E. coli and K. pneumoniae; MIC = 250 µg/mL). Chitosan (10 kDa) was mainly active against E. coli, K. pneumoniae, P. aeruginosa and S. salivarius (MIC = 500 µg/mL) whereas chitosan (100 kDa) was active only against C. albicans (MIC = 250 µg/mL). Chlorhexidine solution inhibited the growth of all test organisms with complete eradication. However, the anti-candida activity of curcumin (MIC = 16 µg/mL) is higher than that of chlorhexidine (MIC = 400 µg/mL) [2]. It was found that curcumin at the concentration of 0.1% w/v with chitosan at the concentration of 0.5% w/v (chitosan-curcumin mouthwash) had distinctive advantage over pure 0.1% w/v curcumin or 0.5% w/v chitosan mouthwash against C. albicans growth, both in free-floating form and in biofilms. The anti-candida activity of the developed mouthwash was comparable to that of a standard chlorhexidine mouthwash. This clinically effective anti-candida property of the non-irritant chitosan-curcumin mouthwash recommended its potential prophylactic alternative to prevent candidiasis in high risk patients such as cancer and immunocompromised patients.

[1] Anjana D, et al. Am J Infect Dis 2012; 8: 41 – 49.

[2] Lamfon, H. et al. J Antimicrob Chemother 2004; 53: 383 – 385.