Delivery of antifungal agents to the oral cavity

Abstract

There is scant information in the literature on the local delivery of antifungal agents within the mouth. Research, therefore, is warranted to evaluate the optimal vehicle for the delivery of the agents to the oral mucosa. A major difficulty for the successful eradication of fungal infections appears to be the dilution and rapid elimination of the drugs from the oral cavity due to the flushing action of saliva. This problem may partly be circumvented by the discovery of the newer triazoles which appear to be effective for most oral candidoses, with only a single dose administration per day and the drug delivered via the systemic route. Nonetheless, whether such newer drugs, with a wide spectrum of activity and minimal toxicity, should be used routinely for oral candidoses merits consideration as emergence of resistant organisms to the triazoles have been now been reported. Accordingly, topical delivery of antifungals remains the most widely accepted approach, with techniques aimed at prolonging drug inhibitory concentrations in the oral cavity. Since most antifungals do not possess inherent ability to bind to oral mucosa, this goal may best be achieved through improved formulations. | There is scant information in the literature on the local delivery of antifungal agents within the mouth. Research, therefore, is warranted to evaluate the optimal vehicle for the delivery of the agents to the oral mucosa. A major difficulty for the successful eradication of fungal infections appears to be the dilution and rapid elimination of the drugs from the oral cavity due to the flushing action of saliva. This problem may partly be circumvented by the discovery of the newer triazoles which appear to be effective for most oral candidoses, with only a single dose administration per day and the drug delivered via the systemic route. Nonetheless, whether such newer drugs, with a wide spectrum of activity and minimal toxicity, should be used routinely for oral candidoses merits consideration as emergence of resistant organisms to the triazoles have now been reported. Accordingly, topical delivery of antifungals remain the most widely accepted approach, with techniques aimed at prolonging drug inhibitory concentrations in the oral cavity. Since most antifungals do not possess inherent ability to bind to oral mucosa, this goal may best be achieved through improved formulations.