Chemosensitization of Drug Resistant Candida albicans Biofilms A Combinatorial approach

Abstract

Candida albicans is a commensal of the human gastrointestinal, urinogenital and oral tract where in it lives without any adverse effects to the host. Device related infections caused by biofilm forms of Candida albicans are life threatening because of their increased tolerance to antifungal drugs. Combinatorial therapy involving combination of phytochemicals with fluconazole and Diclofenac sodium would be an effective approach against drug resistant Candida biofilms. We have evaluated the efficacy of some of the components of lemongrass oil in combination with fluconazole, and Diclofenac in combination with three phytochemicals against planktonic and biofilm forms of C.albicans. Along with that we have tested, anti-inflammatory activity of Diclofenac sodium in combination with Eugenol, Thymol and Carvacrol in Carrageenan induced paw edema in a rat model. Activities of various combinations were analyzed by chequerboard format. Interactions between these combinations were determined by calculating fractional inhibitory concentration indices (FICI) and results obtained by XTT metabolic assay were confirmed by scanning electron microscopy. Nerol, Citral, Linalool, and#946;-ionone, Terpinolene, 1, 8 Cineol, Geraniol and Geranyl acetate in combination with fluconazole showed synergistic interaction against developing biofilm of C.albicans.Whereas Nerol, Geraniol and and#946;-ionone with fluconazole combination showed synergistic interaction and inhibited mature biofilms of C.albicans. We found that Diclofenac acted synergistically with Eugenol, Thymol and carvacrol against planktonic as well as biofilm forms of C.albicans. Our data confirmed that, Eugenol, Thymol and Carvacrol are efficacious in anti-inflammatory action in combination with Diclofenac sodium in rat paw edema at low concentration. newline