Drug Delivery Systems That Eradicate and/or Prevent Biofilm Formation - Antibiofilm Agents: From Diagnosis to Treatment and Prevention - page 401

Table 1 Liposomal formulation of antifungal agents in clinical trial
Product
name

Active
drug

Route of
injection

Approved
indication

Trial
phase Reference

Nyotran Nystatin Intravenous Systemic

fungal
infection

Phase
I/II

Immordino et al. ( 2006 )

AmBisome Amphotericin-B Intravenous Fungal
infections

Phase
II/III

Immordino et al. ( 2006 ),
Meunier et al. ( 1991 )

Abelcet Amphotericin-B Intravenous Sever fungal

infections

Phase
I/II

Enzon Pharmaceuticals,
Wasan and
Lopez-Berestein ( 1996 )

Amphotec Amphotericin-B Intravenous Sever fungal
infections

Phase
II/III

Denning et al. ( 1994 ),
Three Rivers
Pharmaceuticals

Between the cationic and anionic liposomes used to deliver the bactericide
Triclosan to Streptococcus salivarius DBD and Streptococcus sanguis C104
biofilms and their mixed biofilms, anionic liposomes were most effective in
inhibiting the growth of S. sanguis C104 biofilms, whereas growth of
S. salivarius DBD could not be effectively inhibited by liposomal Triclosan.
Growth inhibition of mixed biofilms by liposomal Triclosan reflected the effects
found on the single species biofilms, whereas anionic liposomes inhibited the
growth of biofilms with a high content of S. sanguis C104 (Robinson et al. 2001 ).
Additionally, confocal laser scanning microscopy has been used to visualize the
adsorption of fluorescently labeled liposomes on immobilized biofilms of the
bacterium Staphylococcus aureus (Ahmed et al. 2002 ).
Liposomes can target matrix or biofilm cells by specific attachment, allowing the
drug to be released in the vicinity of the microorganisms; although, in the case of
adhesion of yeast cells to human cells, further study is needed on the ability of these
systems to prevent adhesion but not affect adhered cells. So, this nanotechnology is
indeed a promising research area, but requires more studies to fully understand the
mechanism behind the antimicrobial activity.

2.2 Niosome-Based Drug Delivery Systems

Niosomes are nonionic surfactant vesicles constructed by the hydration of synthetic
nonionic surfactants, with or without amalgamation of cholesterol or other lipids.
They are also called nonionic surfactant vesicles (NISV) or novasomes (Brewer and
Alexander 1994 ; Gupta et al. 1996 ). They are vesicular systems similar to lipo-
somes that can be used as carriers of amphiphilic and lipophilic molecules but have
a better stability and release profile (Mukherjee et al. 2007 ), lower cost, and less