Assessing the antifungal effect of a combination of fluconazole and tithon a diversifolia leaf extract against candida albicans
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Date
2020-11-02Author
Oonyu, Richard
Nyiiro, Grant
Nadiope, Wilber
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Background: Candida albicans remains the most common cause of candidiasis of the 30 species
that have the ability to infect humans. It affects the oral and vaginal mucosa as well disseminated
blood stream and deep tissue infections mainly in the immunocompromised. It’s managed with
azoles, polyene among others but majorly azoles are used because they are relatively cheap, less
toxic and effective, however there are reports of development of resistance to these. combination
therapy is one of the ways to manage these infections. The azoles are currently combined with
amphotericin which is toxic even at therapeutic dose. Tithonia diversifolia leaf extract has
activity against Candida albicans. This study therefore aimed at stems for a need for another
safe, effective drug that can be combined with azoles to reduce development of resistance.
Objectives: To assess the antifungal activity of a combination of ethanolic extract of Tithonia
diversifolia and fluconazole against candida albicans.
Method: The extraction was done by maceration in alcohol 70%, and then evaporation using a
rotary evaporator to obtain the extract, the extract and fluconazole was tested for antifungal
activity using well diffusion method, the MICs were determined by plotting a graph of square of
radius of inhibition against log concentration and the nature of activity of combination was
elucidated by use of FICI equation. The significance of combination using Graphpad prism 8.0.2
Results: The antifungal activities in terms of MICs of Fluconazole, fluconazole in combination,
extract and extract in combination were (0.973, 1.169, 3.774 and 4.073) mg/ml respectively. The
combination showed antagonistic activity as illustrated by the FIC index of 2.28.
There was no significance difference between the effect of combination and fluconazole
(p=0.586, ordinary one-way ANOVA), and combination and extract (p=0.231, ordinary one-way
ANOVA).
Conclusion and recommendation: Fluconazole showed better activity than extract against
candida albicans, however the combination did not show synergistic activity, but rather
antagonistic activity and it’s therefore not recommended for use against Candida albicans., but
rather the extract alone
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