Abstract
Candida spp. is the most prevalent species causing systemic fungal infections. The effect of antifungal agents were screened in vitro and their synergism effect were determined between hydroxychavicol (HC) in association with commercialized antifungal drugs—amphotericin B (AMB), and 5-fluorocytosine (5-FC) alone and in combination against five different oral Candida spp. in their planktonic states at different ratio (1:1 v/v; 1:2 v/v and 2:1 v/v). In vitro susceptibilities of Candida spp. to HC and commercialized antifungal agents were investigated by broth microdilution method as described by Clinical and Laboratory Standards Institute M38-A2. The intensity of the interactions was evaluated by visual reading and spectrophotometric method in checkerboard microdiluton assay, and the nature of the interactions was assessed by fractional inhibitory concentration index. The minimum inhibitory concentration (MIC50) of HC, AMB and 5-FC alone against five different planktonic oral Candida spp. ranged from 240 to 120, 8 to 15, and 2 to 8 µg/mL respectively. Positive synergistic effect existed between HC and AMB at 1:1 ratio in all Candida spp. However, there was no synergy effect observed in the majority of Candida spp. for the combination of HC with 5-FC. The data of combination between HC with AMB may be useful in the treatment of systemic infections caused by oral Candida spp. instead of the combination of HC with 5-FC.
Highlights
Invasive fungal infections, such as candidiasis, represent a public health problem of major importance
Candida strains and growth condition Five strains of Candida spp. used in this study were purchased from The American Type Culture Collection (ATCC), USA
amphotericin B (AMB) alone was active against C. tropicalis and C. dubliniensis at minimum inhibitory concentrations (MIC) of 4 μg/mL, C. albicans and C. parapsilosis at MIC, of 8 μg/mL and C. lusitaniae at MIC of 15 μg/ mL
Summary
Invasive fungal infections, such as candidiasis, represent a public health problem of major importance. Since its discovery in 1839 by Langenbeck, the genus Candida has been shown to be the causative agent of many infections and represent a component of the normal flora in the oral cavity (Fridkin and Jarvis 1996). HC is the major phenolic component, isolated from the aqueous extract of P. betle L., leafand has been reported to exhibit antibacterial activities against oral cavity pathogens (Sharma et al 2009) by inhibit the growth and disrupt the permeability barrier of microbial membrane structures. The report on its antifungal activity is lacking Polyenes such as AMB (isolated from Streptomycin spp.) bind to ergosterol and disrupt the major lipid component of the fungal cell membrane. From 1950s until the discovery of the azoles, polyenes antifungal agents
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