Evaluation of the Antifungal Effect of Fluconazole and Silymarin against Candida Albicans in Vitro and in Vivo”
Abstract
Background: Cutaneous candidiasis has been considering to be a major public health problem and opportunistic infection affect skin and mucus membrane. if left untreated it leads to serious dermal, mucus, systemic complications. Fluconazole is effective in the treatment of cutaneous and systemic candidiasis. Resistance of candida albicans to fluconazole has led to choose an alternative therapy. Dietary supplement silymarin have antifungal activity against candida albicans.
Objective: This study was carried out to evaluation of the antifungal effect of Fluconazole and Silymarin alone against drug resistant Candida albicans isolates and evaluation combination therapy between silymarin and fluconazole to overcome problem of resistance. Material and Method: A cutaneous candidiasis in adult male rats model was used to assess Fluconazole and Silymarin efficacy in vivo in treating Candida albicans infections. in vitro minimum inhibitory concentrations (MICs) determined by broth micro dilution. the antifungal efficacy was determined by measuring the zone of inhibition in a well diffusion experiment.
Results: The current study included performing a series of dilutions of 100µg to a concentration of 0.4µg for the determining the minimum inhibition concentration of drugs on Candida albicans the MIC was 33.3 µg for Silymarin and 11.1 µg for Fluconazole. Antifungal assay alone of silymarin (60µg) show best and large inhibition zone (15.8mm) compare to (33.3µg) show inhibition zone (12.7 mm) and (15 µg) show small inhibition zone. Antifungal assay of silymarin in combination with fluconazole (60 - 11µg) show large inhibition zone (37.9mm) compare to (33.3- 11µg) show less inhibition zone (26.9 mm) and last combination (15- 11µg) show small inhibition zone (17.2mm). Animal study of silymarin show the best combination with fluconazole give faster healing time and reduce size of infection from 2 cm to 0.4 cm and disappear redness of skin and return growth of hair is 60- 11µg. Effectiveness of silymarin against Candida albicans increases when the antibiotic is mixed with fluconazole and the effectiveness also increase with an increase in the concentration of silymarin.
Conclusion. The effect of silymarin was increased proportionally with increasing the concentration. The mean inhibition zone of silymarin was the highest with higher doses in a statistically significant relation. A synergistic effect of fluconazole and silymarin with the most effective concentration being statistically significant. The rats treated with a combination of fluconazole and the silymarin 60-11µg concentration reached 100% healing within 15 days in a statistically significant relation.