Abstract
(1) Background: Few antifungal drugs are currently available, and drug-resistant strains have rapidly emerged. Thus, the aim of this study is to evaluate the effectiveness of the antifungal activity from a combinational treatment of chitosan with a clinical antifungal drug on Candida albicans and Candida tropicalis. (2) Methods: Minimum inhibitory concentration (MIC) tests, checkerboard assays, and disc assays were employed to determine the inhibitory effect of chitosan with or without other antifungal drugs on C. albicans and C. tropicalis. (3) Results: Treatment with chitosan in combination with fluconazole showed a great synergistic fungicidal effect against C. albicans and C. tropicalis, but an indifferent effect on antifungal activity when challenged with chitosan-amphotericin B or chitosan-caspofungin simultaneously. Furthermore, the combination of chitosan and fluconazole was effective against drug-resistant strains. (4) Conclusions: These findings provide strong evidence that chitosan in combination with fluconazole is a promising therapy against two Candida species and its drug-resistant strains.
Highlights
The incidence of fungal infections has increased significantly in recent decades
Many review articles have implied that the major mechanism of chitosan against microorganisms is the targeting of the cell wall and cell membrane [4,5,6,7,17,19,22,23,24,31]
The in vitro antifungal activities of fluconazole, amphotericin B, caspofungin, and chitosan with different properties were analyzed against C. albicans SC5314
Summary
The incidence of fungal infections has increased significantly in recent decades. Current epidemiological surveys have reported that Candida species are the leading causes of nosocomial bloodstream infections, which can lead to high mortality rates in at-risk populations [1,2]. The issues of currently available antifungal drugs include undesirable side effects and therapeutic failure of the antifungal treatment against drug-resistant strains. Chitosan shows considerable antimicrobial activity against a variety of bacteria and fungi [5,6,7,14,15,16,17,18,19,20,21,22,23,24,25]. Chitosan has been suggested to exhibit polycationic polymers when the environmental pH is below 6.5 [17,21,23], which leads to interactions with the negatively charged bacterial or fungal cell surface, thereby causing an inhibitory effect [6,7,8,22,23,24]
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