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ObjectivesThis study evaluated antimicrobial activity of atorvastatin, pravastatin, rosuvastatin, and simvastatin against oral bacteria, and the interaction of simvastatin with standard antimicrobials (amoxicillin and metronidazole).MethodsMinimal inhibitory concentration assays were performed with Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Actinomyces odontolyticus, Streptococcus oralis, Streptococcus mitis, Streptococcus salivarius, Streptococcus sanguinis, and Streptococcus gordonii; checkerboard microdilution assays between simvastatin and standard antimicrobials; monospecies and multispecies biofilms.ResultsSimvastatin showed the best antimicrobial activity against most species (MIC range from 3.12 to 25 μg/ml), highlighting the sensitivity of P. gingivalis. In the checkerboard assay, synergistic interaction was found between simvastatin and amoxicillin against S. oralis and S. sanguinis. P. gingivalis biofilm was inhibited by simvastatin at 10 and 50× Minimal inhibitory concentration, with similar effects to metronidazole. For multispecies biofilm, SMV reduced the biofilm metabolic activity (79%) and total counts (87%), comparable to amoxicillin. Simvastatin also reduced bacterial counts of Veilonnella parvula, P. gingivalis, Streptococcus mutans, Actinomyces naeslundii, P. intermedia, and Capnocytophaga ochracea in the multispecies biofilm.ConclusionsSimvastatin showed antimicrobial and antibiofilm activity against oral bacteria and may contribute to the control of dysbiosis, and may be considered in clinical studies as an adjuvant in the treatment of periodontitis.

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Probiotics are microorganisms that live in symbiosis with the human body. The intake of probiotics in adequate amounts can improve biological functions bringing improvements in the health of the host. Many studies have demonstrated the indisputable antimicrobial activity of probiotics and their potential for an alternative treatment of infections. Nevertheless, the forms of encapsulation, as well as clinical trials on the clinical use of these microorganisms as a recognized and well-established protocol, are still incipient. In this chapter, we provide a general approach to the topic and point to future directions in the probiotics field for this purpose. Moreover, microbial resistance is a current public health problem and the search for new therapeutic alternatives is urgent. Probiotics and other natural therapies have been considered very promising. The approaches of future research should focus mainly on the isolation of new probiotic microorganisms, the definition of inoculum, forms of encapsulation for controlled delivery, and clinical trials for the definition of doses and mechanism of action in the fight against infections.