Abstract
The aim of this study was to determine the minimum inhibitory concentration of carvacrol and to evaluate the antifungal activity of carvacrol when combinated with fluconazole, ketoconazole or amphotericin B against non-albicans Candida species. MICs were determined using microdilution method, and the combination study was conducted using the checkerboard method. The carvacrol MIC ranged between 128 and 512 μg/mL. The greatest antifungal activity was displayed with ketoconazole. Conversely, fluconazole displayed the lowest activity. Amphotericin B showed MICs ranging from 0.5 to 2 μg/mL. The best combinations were observed against Candida guilliermondii and Candida parapsilosis, which presented synergistic efects. Additive efect was observed in three combinations, whereas, indifferent interactions were seen in six combinations. No antagonistic effects were observed. Based on these results, we conclude that carvacrol retains high activity against non-albicans Candida strains, and the combinations between carvacrol and the antifungals tested yielded significant effects.
Highlights
The incidence and prevalence of fungal infections caused by species of Candida are increasing rapidly, especially in large populations of immunocompromised patients and/or those hospitalized with underlying grave diseases [1]
C. albicans is the most prevalent species involved in invasive fungal infections, the incidence of infections caused by non-albicans species has increased significantly in recent years [3]
In accordance with the values proposed by Sartoratto et al (2004) [18], values of Minimum inhibitory concentration (MIC) between 50 - 500 μg/mL are to be considered as high activity; values from 600 - 1,500 μg/mL as medium activity; and those above 1,500 μg/mL as low activity
Summary
The incidence and prevalence of fungal infections caused by species of Candida are increasing rapidly, especially in large populations of immunocompromised patients and/or those hospitalized with underlying grave diseases [1]. Candida spp. are considered opportunistic microorganisms present in the normal microbiota of the oral cavity, gastrointestinal tract and urogenital tract in humans. They can become pathogenic species when there is weakening of the host defense system through multiple risk factors [2]. C. albicans is the most prevalent species involved in invasive fungal infections, the incidence of infections caused by non-albicans species has increased significantly in recent years [3]. The high prevalence of non-albicans Candida species.
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