Usnic acid revisited, its activity on oral flora

The antibacterial activity of usnic acid, the most widely distributed antibiotic among the numerous ones produced by many lichen species has been re-examined and particular attention has been devoted to the activity of optically active forms of usnic acid against Streptococcus mutans. The D(+) enantiomer was found to be more active than the L(+) form and was observed to exert a rather selective activity against S. mutans. Trials carried out in volunteers showed that mouth-rinse with D(+) usnic acid preparations exerted a selective and long lasting action against S. mutans, without substantially altering the equilibrium of normal oral bacterial flora. The adherence of S. mutans to smooth surfaces is not increased by the presence of subinhibiting concentrations of D(+) usnic acid. This is at variance with what has been observed with other antibiotics. These characteristics make D(+) usnic acid a suitable candidate for topical use in oral medicine.