Abstract

Dr. Gerald Ngo Teke*, Penn-Edelqueen Watoh Nkengla, Stephen Lacmata Tamekou, Oumar Mahamat, Christian Vershiyi Junior and Jules Roger Kuiate

ABSTRACT

Background: Fungal pathogen especially opportunistic mycoses of Candida origin has been on a significant increase nowadays. Finding more on the way commonly available antifungal drugs interact could be of interest in maximizing treatment outcomes of patients suffering from fungal infections. Objective: To evaluate the effects of antifungal drug associations on the growth of some Candida species. Method: Fluconazole and clotrimazole (azole) and nystatin and amphotericin B (polyene) were bought from licensed pharmacies. Six fungal clinical isolates were used in this study. Broth microdilution was used to determine the MIC of the different combinations of the antifungal drugs at various concentrations from 512 to 0.0625 ?g/ml. Checker board method and fractional inhibitory concentration index (FICI) were used to determine the interaction patterns when azoles were associated with polyenes. Fungal growth kinetics and effects of various test combinations on total fungal protein levels were evaluated. Data was analyzed using Statistical Package for Social Science. Results: It was observed that interaction patterns for a given combination varied across the studied fungi. FLU+NYS gave s synergistic effect on C. albicans CPC2091 and C. glabbrata but had no interaction the other fungi. FLU+NYS exhibited mostly antagonistic effects on 4/6 of the fungi no interaction on 2/6. The time-kill curves further elucidated synergistic combinations of FLU+NYS and CLO+NYS. The combined effect fluconazole with nystatin on C. albicans CPC2091 increased fungal proteins at all concentrations on like clotrimazole and nystatin on C. dubliniensis. Conclusion: The antifungal drug interactions studied in this paper showed varying synergistic, no interaction and antagonistic patterns on the studied fungi based on types of drugs associated. Use of fungal drug combination therapy warrants proper diagnosis of disease agent and knowledge of drug association effects.