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Antifungal Activity of Capric Acid, Nystatin, and Fluconazole and Their in Vitro Interactions Against Candida Isolates From Neonatal Oral Thrush Publisher Pubmed



Khalandi H1 ; Masoori L2, 3 ; Farahyar S1, 4 ; Delbandi AA5 ; Raiesi O6, 7 ; Farzanegan A8 ; Khalandi G9 ; Mahmoudi S1 ; Erfanirad T1 ; Falahati M1
Authors
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Authors Affiliations
  1. 1. Department of Medical Parasitology and Mycology, School of Medicine, Iran University of Medical Science, Tehran, Iran
  2. 2. Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
  3. 3. Department of Laboratory Sciences, School of Allied Medical Sciences, Lorestan University of Medical Sciences, Khorramabad, Iran
  4. 4. Microbial Biotechnology Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  5. 5. Immunology Research Center, Immunology and Infectious Disease Institute, Iran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Department of Parasitology, School of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran
  8. 8. Department of Parasitology and Mycology, Guilan University of Medical Science, Anzali International Campus, Guilan, Iran
  9. 9. Faculty of Physics, University of Tabriz, Tabriz, Iran

Source: Assay and Drug Development Technologies Published:2020


Abstract

Due to the increasing resistance of various Candida species to azole drugs, particularly fluconazole, it would be of significant importance to look for alternative therapies. The aim of this study was to investigate the antifungal activity of capric acid and its in vitro interactions with nystatin and fluconazole against Candida isolates. A total of 40 Candida isolates (C. albicans, 36; C. kefyr, 2; C. tropicalis, 1; C. glabrata, 1) collected from the oral cavity of neonates with oropharyngeal candidiasis and a reference strain of C. albicans (ATCC 10231) were used in this study. Antifungal activity of capric acid and two comparator antifungal drugs, namely fluconazole and nystatin, was tested according to CLSI M27-A3/M60 method. The in vitro interaction between capric acid with fluconazole and nystatin was determined following a checkerboard method and results were interpreted using fractional inhibitory concentration index. Nystatin had the lowest minimum inhibitory concentrations (range, 0.125-8 μg/mL; geometric mean [GM], 0.6229 μg/mL) followed by fluconazole (range, 0.5-16 μg/mL; GM, 1.9011 μg/mL) and capric acid (range, 128-2,048 μg/mL; GM, 835.9756 μg/mL). When tested in combination, capric acid with fluconazole demonstrated synergistic, indifferent, and antagonistic interactions in 3 (7.317%), 24 (58.536%), and 14 (34.146%) cases, respectively. For combination of capric acid with nystatin, synergistic, indifferent, and antagonistic interactions were observed in 1 (2.439%), 19 (46.341%), and 21 (51.219%) cases, respectively. All cases of synergistic interactions were against resistant or susceptible dose-dependent isolates. Fluconazole, nystatin, and capric acid seem to be more effective when they are used alone compared with their combination. However, their combination might be effective on resistant isolates. © Copyright 2020, Mary Ann Liebert, Inc., publishers 2020.
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