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Front. Microbiol. | doi: 10.3389/fmicb.2018.00837

Miconazole-Urea in A Buccal Film as A New Trend For Treatment of The Resistant Mouth Fungal White Patches

 Omar Y. Mady1, Ahmed M. Donia1 and  Lamiaa Al-Madboly1*
  • 1Faculty of Pharmacy, Tanta University, Egypt

A growing concern about Candida albicans is the emergence of high incidence of resistance against antifungal agents, which requires searching for new medications or improving the response to the existing members. The objective of this work was to evaluate the effectiveness of the miconazole in the absence and presence of urea, as a penetration enhancer, against C. albicans. In addition to, formulating both of them in a polymer film to be used topically for treatment of mouth fungal white patches caused by C. albicans. A synergistic effect was recorded between this imidazole and urea against the test strain. Miconazole MIC (32 mg/L) was dramatically reduced to 0.0625 mg/L following combination with urea. Transmission electron microscopy explained the mechanisms of action mediated by the test agents. Minimal fungicidal dose of miconazole combined with urea showed early apoptotic cells with condensed chromatin and small blebs. Cytoplasmic leakage and necrosis in some cells was observed at high fungicidal dose. Buccal bioadhesive films were prepared using increasing values of the drug MIC and urea. The physicochemical characters of the prepared films including; film weight, thickness, swelling index, drug content, folding endurance, surface pH, bioadhesion force and time and drug release kinetics, were studied. Microbiological evaluation of all prepared films showed an increase in the inhibition zone diameters for films containing increasing concentrations of both miconazolae and urea in a concentration-dependent manner (30-40 mm) compared to miconazole alone (18 mm). Based on our results, the prepared films are promising for buccal administration of miconazole/urea showing synergistic effect for treatment of C. albicans infection.

Keywords: Bioadhesive film, C. albicans, Miconazole, Urea, MIC

Received: 02 Feb 2018; Accepted: 12 Apr 2018.

Edited by:

Hector Mora Montes, Universidad de Guanajuato, Mexico

Reviewed by:

Luis A. Pérez-García, Universidad Autónoma de San Luis Potosí, Mexico
Monika Staniszewska, National Institute of Public Health - National Institute of Hygiene  

Copyright: © 2018 Mady, Donia and Al-Madboly. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Lamiaa Al-Madboly, Faculty of Pharmacy, Tanta University, Tanta, 31111, Egypt,