Assessing the antifungal effect of a combination of fluconazole and tithon a diversifolia leaf extract against candida albicans

Abstract

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 1