Khan Gayasuddin, Yadav Sarita K, Patel Ravi R, Nath Gopal, Bansal Monika, Mishra Brahmeshwar
Department of Pharmaceutics, Indian Institute of Technology, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India.
Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
AAPS PharmSciTech. 2016 Dec;17(6):1312-1325. doi: 10.1208/s12249-015-0466-y. Epub 2015 Dec 21.
Metronidazole (MZ) and levofloxacin (LF) are widely employed for treatment of periodontitis, but high oral dose and resistance development after long-term oral administration limit their use. The aim of this study was to alleviate shortcomings in the treatment of periodontitis by fabrication of intrapocket, biodegradable films of chitosan (CS) loaded with MZ and LF meant for inserting into periodontal pockets to treat infections. The films were developed by solvent casting technique using propylene glycol as plasticizer and glutaraldehyde as crosslinking agent. Their physical characteristics, such as drug content, surface pH, swelling index, and folding endurance, exhibited results within limit. Further, FTIR and DSC studies revealed stability of films and compatibility between drugs and excipients. SEM images of films showed the presence of free drug particles on the surface causing burst effect. In vitro release in McIlvaine buffer pH 6.6 was of sustained nature assisted by the burst effect. CS and crosslinking agent concentrations negatively affected drug release and positively affected T (time for releasing 90% of the drug) due to altered matrix density. In contrast, the plasticizer concentration increases membrane permeability and hence increased drug release, lowering T. Crosslinked films demonstrated sustained release up to 7 days. The antibacterial efficacy of films was tested on Staphylococcus aureus and Escherichia coli, indicating good antibacterial activity. Clinical trials on patients proved the therapeutic efficacy of the films by a significant (p < 0.05) decrease in the clinical markers of periodontitis, i.e. gingival index, plaque index and pocket depth. Conclusively, the films of MZ and LF were successful tools for the management of periodontitis.
甲硝唑(MZ)和左氧氟沙星(LF)被广泛用于治疗牙周炎,但口服剂量高以及长期口服后产生耐药性限制了它们的应用。本研究的目的是通过制备载有MZ和LF的壳聚糖(CS)袋内可生物降解薄膜来缓解牙周炎治疗中的不足,该薄膜用于插入牙周袋以治疗感染。薄膜通过溶剂浇铸技术制备,使用丙二醇作为增塑剂,戊二醛作为交联剂。它们的物理特性,如药物含量、表面pH值、溶胀指数和耐折性,结果均在限度内。此外,傅里叶变换红外光谱(FTIR)和差示扫描量热法(DSC)研究表明薄膜稳定,药物与辅料之间具有相容性。薄膜的扫描电子显微镜(SEM)图像显示表面存在游离药物颗粒,导致突释效应。在pH 6.6的麦基尔维恩缓冲液中进行的体外释放具有持续性质,受突释效应辅助。由于基质密度改变,CS和交联剂浓度对药物释放有负面影响,对T(释放90%药物的时间)有正面影响。相比之下,增塑剂浓度增加了膜的通透性,从而增加了药物释放,降低了T。交联薄膜显示持续释放长达7天。对薄膜的抗菌效果在金黄色葡萄球菌和大肠杆菌上进行了测试,表明具有良好的抗菌活性。对患者的临床试验证明了薄膜的治疗效果,牙周炎的临床指标即牙龈指数、菌斑指数和牙周袋深度显著降低(p < 0.05)。总之,MZ和LF薄膜是治疗牙周炎的成功工具。