Volume 14, Issue 5 (Sep-Oct 2020)                   mljgoums 2020, 14(5): 25-29 | Back to browse issues page

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Shamoushaki T, Fozouni L. Fluconazole and Ibuprofen Combination: A Potential Treatment for Mucosal Candidiasis. mljgoums. 2020; 14 (5) :25-29
URL: http://mlj.goums.ac.ir/article-1-1257-en.html
1- Department of Biology, Gorgan Branch, Islamic Azad University, Gorgan, Iran
2- Department of Biology, Gorgan Branch, Islamic Azad University, Gorgan, Iran , lili_kia@yahoo.com
Abstract:   (500 Views)
Background and objectives: The incidence of drug-resistant candidiasis has increased dramatically. This study aimed to evaluate antifungal effects of fluconazole alone and in combination with ibuprofen on isolates from patients with mucosal candidiasis.
      Methods: Candida species isolates from 142 patients with suspected mucosal (oral and vaginal) candidiasis were identified by culture on CHROMagar Candida medium and carbohydrate assimilation test using the API 20CAUX kit. Minimum inhibitory concentration (MIC) of fluconazole alone and in combination with ibuprofen was determined by the broth microdilution method.
      Results: Among isolates, 43.7% were identified as Candida species (Candida albicans, Candida glabrata, Candidia parapsilosis, Candida tropicalis, Candida guilliermondii and Candida kefyr). The highest rate of fluconazole resistance was observed among C. albicans (50%) isolates. MIC90 of ibuprofen-fluconazole combination against C. albicans isolates was 32 μg/mL, which was 8-fold less than that of fluconazole alone (MIC90=256 μg/mL) (P<0.01). Moreover, the MIC90 of fluconazole-ibuprofen combination against C. parapsilosis isolates was 4-fold less than that of fluconazole alone.
      Conclusion: Our results revealed partial fluconazole resistance among Candida isolates from patients with mucosal candidiasis. However, the resistance rate decreased 2.5 fold following treatment with the ibuprofen-fluconazole combination. Therefore, it is recommended to further investigate the therapeutic potential of this drug combination for treatment of fungal infections, such as candidiasis.
Full-Text [PDF 719 kb]   (93 Downloads)    
Type of Study: Original Paper | Subject: Microbiology
Received: 2019/10/14 | Accepted: 2020/05/3 | Published: 2020/08/24 | ePublished: 2020/08/24

1. Maznei kova V. Vaginal candidiasis treatment protocols using miconazole and fluconazde. Akush ginekol (sofila). 2003; 42: 30-40.
2. Matar MJ, Ostrosky-Zeichner L, Paetznick VL, Rodriguez JR, Chen E, Rex JH. Correlation between ETest, Disk Diffusion, and Microdilution methods for antifungal susceptibility testing of fluconazole and voriconazole. Antimicrob Agents Chemother. 2003; 47(5): 1647-51. doi: 10.1128/aac.47.5.1647-1651.2003. [DOI:10.1128/AAC.47.5.1647-1651.2003]
3. Pappas PG, Kauffman CA, Andes D, Benjamin DK Jr, Calandra TF, et al. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009; 48(5): 503-35. doi: 10.1086/596757. [DOI:10.1086/596757]
4. Ahmad A, Khan AU. Prevalence of Candida species and potential risk factors for vulvovaginal candidiasis in Aligarh, India. Eur J Obstet Gynecol Reprod Biol. 2009; 144(1): 68-71. doi: 10.1016/j.ejogrb.2008.12.020. [DOI:10.1016/j.ejogrb.2008.12.020]
5. Cherif A, Khrouf N, Jabnoun S, Mokrani C, Amara MB, Guellouze N, et al. Randomized pilot study comparing oral ibuprofen with intravenous ibuprofen in very low birth weight infants with patentductus arteriosus. Pediatrics. 2008; 122: 1256-61. doi: 10.1542/peds.2008-1780. [DOI:10.1542/peds.2008-1780]
6. World Health Organization. WHO Model List of Essential Medicines. 20th ed. 2017.
7. Clinical and Laboratory Standards Institute (CLSI). Reference method for broth dilution antifungal susceptibility testing of yeasts. 3rd ed. Pennsylvania:Wayne, PA. 2008.
8. Badiee P, Alborzi A, Shakiba E, Ziyaeyan M, Rasuli M. Molecular Identification and in-vitro susceptibility of Candida albicans and C. dubliniensis Isolated from Immunocompromised Patients. Iranian Red Crescent Medical Journal. 2009; 11(4): 391-97.
9. Richter S, Rudolph P. Antifungal Susceptibilities of Candida Species Causing Vulvovaginitis and Epidemiology of Recurrent Cases. Clin Microbiol. 2005; 43(5): 2155-62. doi: 10.1128/JCM.43.5.2155-2162.2005. [DOI:10.1128/JCM.43.5.2155-2162.2005]
10. Mirhendi SH, Makimura K, Shidfar MR Hosseinpour L. Identification and Frequency of Candida Patients isolates by Chromagar candida method. Avicenna Journal of clinical Medicine. 2007; 13(4):11-15.
11. Aghamirian M, keshavarz D, Jahani Hashemi H, sadeghi Qazvini M. Agents associated with candida vulvovaginitis in women referred to health centers in Qazvin. J Qazvin Univ Med Sci. 2007; 11(3): 35-9.
12. Nasrollahi Omran AA, Vakilli L, Jafarpur M. Determination of Vaginal Candidiasis in Women Referred to Shahid Rajaei hospital in Tonekabon(2009-2010). Medical Laboratory Journal. 2011; 5(1): 1-7.
13. Jamilian M, Mashadi E, Sarmadi F, Banijamali M, Farhadi E, Ghanatpishe E. Frequancy of vulvovaginal Candidiasis species in nonpregnant 15-50 years old women in spring 2005 in Arak. J Arak Uni Med Sci. 2007; 10(2): 7-14.
14. Sobel JD, Wiesenfeld HC, Martens M, Danna P, Hooton TM, Rompalo A, et al. Maintenance Fluconazole Therapy for Recurrent Vulvovaginal Candidiasis. N Engl j Med. 2004; 351: 876-83. [DOI:10.1056/NEJMoa033114]
15. Nouraei S, Amir Ali Akbari S, Jorjani M, Alavi Majd HM, frakhteh A, Ghaforian A, et al. Comparison Between the Effect of Fluconazole and Oral Protexin Combination and Fluconazole on the Treatment of Vulvovaginal Candidiasis. J Arak Uni Med Sci. 2013; 16(4):62-73.
16. Nowrozi H, Kazemi A. The Effect of Ultraviolet (UV) Radiation Duration on Drug Susceptibility Testing of Rhizopus spp. to Amphotericin B, Itraconazole and Fluconazole. JSSU. 2014; 22(1): 850-57.
17. Nozari SH, Haydari Kohan F, Ashrafi Khozani M, Ahmadi F, Ghasemi Z, Nami S, et al. Comparison of Antifungal Effect of Fluconazole alone and in Combination with Nanosilver Particles against Candida spesies Isolated from Chronic Candidal Vulvovaginitis. Razi Journal of Medical Science. 2012; 18(93): 8-14.

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