Methods: Poly-ethyl methacrylate and tetrahydro-furfuryl methacrylate (PEM/THFM) discs impregnated with chlorhexidine (n=50), fluconazole (n=50) and drug-free control discs (n=50) were infected with 2x106 cells of Candida albicans ATCC 90028. Discs were incubated for 2, 7, 14, 21 or 28 days at 37°C. The biofilm metabolic activity and biomass formed on the discs was quantified using XTT reduction assay and crystal violet assay for up to 28 days.
Results: The FLU impregnated discs inhibited biofilm metabolism and biomass by mean of 12.6% and 8.83% respectively compared to the drug-free control discs and the metabolism and the biomass of the biofilms increased continuously up to 28 days. It was shown that fluconazole inhibited C. albicans biofilm formation initially (40% at 48h). In contrast chlorhexidine impregnated discs were highly effective with up to 85% reduction of biofilm metabolism and 75% reduction in biomass during the 28-day incubation.
Conclusions: Our findings show the superior efficacy of chlorhexidine impregnation to inhibit biofilm formation compared to fluconazole. These findings indicate the feasibility of introducing a novel remarkable treatment modality for candidal infections. The distinct efficacy of chlorhexidine against C. albicans biofilms is a promising outcome to overcome the side effects of conventional antifungal agents and its reduced efficiency against biofilm formation.