Calcium hydroxide, Daptomycin, Dentinal biofilm, E. faecalis, Gentamicin
Citation Information :
Subbiya A, Gayathri K, Venkatesh A, Padmavathy K, Mahalakshmi K, Mitthra S. Evaluation of the Antibacterial Efficacy of Daptomycin, Gentamicin, and Calcium Hydroxide—Antibiotic Combinations on Enterococcus faecalis Dentinal Biofilm: An In Vitro Study. J Contemp Dent Pract 2021; 22 (2):128-133.
Aim: To evaluate the antibacterial efficacy of calcium hydroxide (CH) with antibiotic combinations: daptomycin and gentamicin against Enterococcus faecalis (E. faecalis) dentinal biofilm.
Materials and methods: Sixty freshly extracted single-rooted mandibular premolars were inoculated with E. faecalis (ATCC 29212) (n = 30) (group A) and clinical isolates (n = 30) (group B) for 3 weeks to form a biofilm. The tooth samples of groups A and B were randomly divided into three subgroups of 10 each, groups 1A and 1B (CH), groups 2A and 2B (CH+G), groups 3A and 3B (CH+D), depending on the medicaments to be placed for one week. The difference between initial and final CFU was calculated and statistically analyzed.
Results: Among the clinical isolates, CH-antibiotic combinations were more effective than CH alone, which was statistically significant (p = 0.006).
Conclusion: The dentinal biofilm of clinical isolates of E. faecalis strains exhibited more reduction in bacterial colonies with CH in combination with antibiotics (D and G).
Clinical significance: Daptomycin and gentamicin when used as an intra-canal medicament in combination with CH are effective in eliminating E. faecalis.
Peikoff MD. Treatment planning dilemmas resulting from failed root canal cases. Aust Endod J 2005;31(1):15–20. DOI: 10.1111/j.1747-4477.2005.tb00201.x.
El Karim I, Kennedy J, Hussey D. The antimicrobial effects of root canal irrigation and medication. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103(4):560–569. DOI: 10.1016/j.tripleo.2006.10.004.
Siqueira JF Jr, Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. Int Endod J 1999;32(5):361–369. DOI: 10.1046/j.1365-2591.1999.00275.x.
Adl A, Shojaee NS, Motamedifar M. A comparison between the antimicrobial effects of triple antibiotic paste and calcium hydroxide against Entrococcus Faecalis. Iran Endod J 2012;7(3):149–155.
Athanassiadis B, Abbott PV, Walsh LJ. The use of calcium hydroxide, antibiotics and biocides as antimicrobial medicaments in endodontics. Aust Dent J 2007;52(1 Suppl):S64–S82. DOI: 10.1111/j.1834-7819.2007.tb00527.x.
Bazvand L, Aminozarbian MG, Farhad A, et al. Antibacterial effect of triantibiotic mixture, chlorhexidine gel, and two natural materials Propolis and Aloe vera against Enterococcus faecalis: an ex vivo study. Dent Res J (Isfahan) 2014;11(4):469–474. DOI: 10.4103/1735-3327.139421.
Jagdale S, Bhargava K, Bhosale S, et al. Comparative evaluation of coronal discoloration induced by two triple antibiotic revascularization protocols when used at varying depths of temporary sealing material at the end of varying time periods. J Conserv Dent 2018;21(4):388–393. DOI: 10.4103/JCD.JCD_117_17.
Hessen MT, Pitsakis PG, Levison ME. Postantibiotic effect of penicillin plus gentamicin versus Enterococcus faecalis in vitro and in vivo. Antimicrob Agents Chemother 1989;33(5):608–611. DOI: 10.1128/aac.33.5.608.
Cantón R, Ruiz-Garbajosa P, Chaves RL, et al. A potential role for daptomycin in enterococcal infections: what is the evidence? J Antimicrob Chemother 2010;65(6):1126–1136. DOI: 10.1093/jac/dkq087.
Geethapriya N, Subbiya A, Padmavathy K, et al. Effect of chitosan-ethylenediamine tetraacetic acid on Enterococcus faecalis dentinal biofilm and smear layer removal. J Conserv Dent 2016;19(5):472–477. DOI: 10.4103/0972-0707.190022.
Ghabraei S, Marvi M, Bolhari B, et al. Minimum intracanal dressing time of triple antibiotic paste to eliminate Enterococcus faecalis (ATCC 29212) and determination of minimum inhibitory concentration and minimum bactericidal concentration: an ex vivo study. J Dent (Tehran) 2018;15(1):1–9.
Kara Tuncer A, Gerek M. Effect of working length measurement by electronic apex locator or digital radiography on postoperative pain: a randomized clinical trial. J Endod 2014;40(1):38–41. DOI: 10.1016/j.joen.2013.08.004.
Birring OJ, Viloria IL, Nunez P. Anti-microbial efficacy of Allium sativum extract against Enterococcus faecalis biofilm and its penetration into the root dentin: an in vitro study. Indian J Dent Res 2015;26(5):477–482. DOI: 10.4103/0970-9290.172041.
Madhubala MM, Srinivasan N, Ahamed S. Comparative evaluation of propolis and triantibiotic mixture as an intracanal medicament against Enterococcus faecalis. J Endod 2011;37(9):1287–1289. DOI: 10.1016/j.joen.2011.05.028.
Estrela C, Sydney GB, Figueiredo JA, et al. Antibacterial efficacy of intracanal medicaments on bacterial biofilm: a critical review. J Appl Oral Sci 2009;17(1):1–7. DOI: 10.1590/s1678-77572009000100002.
Kim D, Kim E. Antimicrobial effect of calcium hydroxide as an intracanal medicament in root canal treatment: a literature review—Part II. in vivo studies. Restor Dent Endod 2015;40(2):97–103. DOI: 10.5395/rde.2015.40.2.97.
Mehta S, Verma P, Tikku AP, et al. Comparative evaluation of antimicrobial efficacy of triple antibiotic paste, calcium hydroxide, and a proton pump inhibitor against resistant root canal pathogens. Eur J Dent 2017;11(1):53–57. DOI: 10.4103/ejd.ejd_159_16.
Molander A, Dahlén G. Evaluation of the antibacterial potential of tetracycline or erythromycin mixed with calcium hydroxide as intracanal dressing against Enterococcus faecalis in vivo. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96(6):744–750. DOI: 10.1016/s1079-2104(03)00361-5.
Kidd JM, Abdelraouf K, Asempa TE, et al. Pharmacodynamics of daptomycin against Enterococcus faecium and Enterococcus faecalis in the murine thigh infection model. Antimicrob Agents Chemother 2018;62(10):e00506–e00518. DOI: 10.1128/AAC.00506-18.
Evans M, Davies JK, Sundqvist G, et al. Mechanisms involved in the resistance of Enterococcus faecalis to calcium hydroxide. Int Endod J 2002;35(3):221–228. DOI: 10.1046/j.1365-2591.2002.00504.x.
Silverman JA, Perlmutter NG, Shapiro HM. Correlation of daptomycin bactericidal activity and membrane depolarization in Staphylococcus aureus. Antimicrob Agents Chemother 2003;47(8):2538–2544. DOI: 10.1128/aac.47.8.2538-2544.2003.
Lakhani AA, Sekhar KS, Gupta P, et al. Efficacy of triple antibiotic paste, moxifloxacin, calcium hydroxide and 2% chlorhexidine gel in elimination of E. faecalis: an in vitro study. J Clin Diagn Res 2017;11(1):ZC06–ZC09. DOI: 10.7860/JCDR/2017/22394.9132.
de Freitas RP, Greatti VR, Alcalde MP, et al. Effect of the association of nonsteroidal anti-inflammatory and antibiotic drugs on antibiofilm activity and pH of calcium hydroxide pastes. J Endod 2017;43(1):131–134. DOI: 10.1016/j.joen.2016.09.014.
Thieme L, Klinger-Strobel M, Hartung A, et al. In vitro synergism and anti-biofilm activity of ampicillin, gentamicin, ceftaroline and ceftriaxone against Enterococcus faecalis. J Antimicrob Chemother 2018;73(6):1553–1561. DOI: 10.1093/jac/dky051.
Luther MK, Arvanitis M, Mylonakis E, et al. Activity of daptomycin or linezolid in combination with rifampin or gentamicin against biofilm-forming Enterococcus faecalis or E. faecium in an in vitro pharmacodynamic model using simulated endocardial vegetations and an in vivo survival assay using Galleria mellonella larvae. Antimicrob Agents Chemother 2014;58(8):4612–4620. DOI: 10.1128/AAC.02790-13.