Nystatin 100,000units/g / Chlorhexidine hydrochloride 1% cream

Background: Antimicrobial photodynamic therapy (aPDT) is a useful adjunct for managing oral biofilm diseases. Natural photosensitizers may be safer and more biocompatible than synthetic ones, but their dental effectiveness is still unclear. Methods: A PRISMA compliant review (PROSPERO ID: CRD420251233910) searched PubMed, Embase, Scopus, and the Cochrane Library for randomized controlled trials published from 2015 to 2025 that used natural photosensitizers for aPDT in dental settings. Three reviewers screened studies, extracted data, and assessed bias with a nine-domain tool adapted for photodynamic therapy. Results: Eleven of 249 records met the established criteria. Natural photosensitizers included curcumin, riboflavin, phycocyanin, chlorophyll derivatives, and plant extracts, tested in periodontitis, peri-implant mucositis, denture stomatitis, caries-related biofilms, and general oral decontamination. Most trials showed short-term microbial reductions and modest clinical gains, with performance comparable to chlorhexidine, methylene blue, or standard care. Adverse effects were minimal. Study quality was generally good, but wide variation in photosensitizer type, light settings, and outcomes, and short follow-up periods hindered meta-analysis and limited conclusions about long-term effectiveness. Conclusions: Natural photosensitizer-based aPDT appears effective and safe as an adjunct, offering consistent short-term microbiological improvements. Current evidence does not support replacing established antimicrobial approaches. Larger, well-controlled trials with standardized methods and longer follow-up periods are needed to define best practice and clarify the role of aPDT in routine dentistry.

Abstract licence: CC BY

Candida auris possesses distinctive features that facilitate its persistence and transmission in healthcare settings, causing outbreaks of infection that are difficult to treat. So, emphasis has been placed on implementing measures for controlling, eliminating, and preventing fungal transmission, such as environmental disinfection and patient decolonization. This review aimed to understand and analyze the agents for environmental disinfection and patient decolonization reported in the last 5 years. The PubMed database was reviewed, using the terms "Candida auris", "disinfection", and "decolonization". Only original papers, published between 2020-2025, in English or Spanish, that included relevant information on the topic, were selected. After the selection process, 52 articles were chosen to analyze the agents for environmental disinfection and decolonization of C. auris. Natural and synthetic disinfectants and ultraviolet radiation were reported for the environmental disinfection, with variable efficacy, depending on factors such as concentration and exposure time. Natural and synthetic antiseptics were also reported for decolonization, with varying efficacy. For example, 2% chlorhexidine shows a 0.5 log reduction, while at concentrations >10% it is >4 log. However, most have only been tested in animal models. Based on the review, Far-UV-C radiation (222 nm) is safe and appropriate to mitigate (up to 1 log reduction) the spread of C. auris in the hospital setting. However, it is important to consider that the cost and limited availability of the device present a barrier to its implementation. Patient decolonization is still challenging nowadays due to the absence of agents with proven high efficacy in humans.

Abstract licence: CC BY