Synergistic Anticandidal Effects of Six Essential Oils in Combination with Fluconazole or Amphotericin B against Four Clinically Isolated <i>Candida</i> Strains

The development of opportunistic pathogenic <i>Candida</i> strains insensitive to several classes of antifungals has emerged as a major health care problem during the last years. Combinational therapy of natural products (e.g., essential oils, EOs) with conventional antifungals has been...

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Bibliographic Details
Main Authors: Bouchra Soulaimani, Elena Varoni, Marcello Iriti, Nour-Eddine Mezrioui, Lahcen Hassani, Abdelaziz Abbad
Format: Article
Language:English
Published: MDPI AG 2021-08-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/10/9/1049
Description
Summary:The development of opportunistic pathogenic <i>Candida</i> strains insensitive to several classes of antifungals has emerged as a major health care problem during the last years. Combinational therapy of natural products (e.g., essential oils, EOs) with conventional antifungals has been suggested as a promising alternative to overcome this medical problem. The present study investigates the potential antifungal activity of EOs extracted from some selected medicinal plants, alone and in combination with two common conventional antifungals (fluconazole and amphotericin B) against four clinical <i>Candida</i> isolates. MIC assays indicated that EOs induced strong anticandidal activities with MIC values ranging from 0.162 to 4.950 mg/mL. The combination of amphotericin B with <i>Thymus leptobotrys</i>, <i>Origanum compactum</i> and <i>Artemisia herba alba</i> EOs provided a synergistic effect against <i>C. krusei</i> only, with MIC gain of four-fold, and additive effect against remaining strains (MIC gain = two-fold). Interesting synergistic interactions were observed by combining all studied EOs with fluconazole, with reduction rates of their MICs ranging from 16 to 512-fold. This synergistic effect was very pronounced with the combination of <i>T. leptobotrys</i> EO and fluconazole. These findings indicate that studied EOs can be used as anti-candidals in combination with antifungals, particularly fluconazole, to counteract the emergence of resistant <i>Candida</i> spp.
ISSN:2079-6382