Comparison of tea tree oil 5%, tea tree oil 10%, and nystatin inhibition zones against vaginal Candida isolates in pregnancy.

INTRODUCTION: Vulvovaginal candidiasis (VVC) in pregnancy frequently develops into recurrent infections. Clinical study suggests that conventional topical treatments for VVC are not always enough to eradicate Candida spp. from the vaginal microenvironment. This study aimed to evaluate the antifungal activity of tea tree oil (TTO) 5% and TTO 10% against Candida species causing VVC in pregnancy. METHODOLOGY: In vitro experimental study was conducted in the Mycology Laboratory at Dermatovenereology Outpatient Clinic Dr. Soetomo General Hospital Surabaya. Eighteen isolates of Candida species were isolated from the vaginal thrush of 15 pregnant women diagnosed with VVC from March to May 2021. Antifungal susceptibility of TTO 5% and TTO 10% was evaluated by the disc diffusion method, with the inhibitory zone diameter as the main outcome. RESULTS: The mean inhibitory zone diameter of TTO 5%, TTO 10%, and nystatin against all Candida spp. was 7.26 mm, 8.64 mm, and 25.57 mm, respectively (p < 0.001). The mean inhibitory zone diameter of TTO 5%, TTO 10%, and nystatin tend to be larger in C. albicans compared to the non-albicans, but the difference is not significant. Nystatin displayed the largest mean inhibitory zone diameters compared to TTO 5% and TTO 10% (p < 0.001) in all Candida species. Increased concentration from TTO 5% to TTO 10% resulted in a slight increment in the mean inhibitory zone diameters in all-Candida species (p = 0.001). CONCLUSIONS: Tea Tree Oil displayed antifungal activity against Candida species causing VVC in pregnancy. Further studies are required to investigate optimal TTO concentrations as a VVC treatment in pregnancy.

Curcumin nanoparticles: the topical antimycotic suspension treating oral candidiasis.

Phytotherapeutics is widely used nowadays as an alternative to the current antifungal drugs to reduce their side effects. Curcumin, with its wide therapeutic array as antioxidant and anti-inflammatory agent, is one of the natural compounds that ha..s an antifungal effect, especially when being used at nanoscale to increase its bioavailability. Our research aimed to evaluate clinically and microbiologically the effect of using topical nanocurcumin suspension to treat oral candidiasis. After 4 days from induction of oral candidiasis (baseline), we randomly divided 39 female BALB/c mice into three groups of 13 animals; nanocurcumin, nystatin, and sham groups. All animals in nanocurcumin and nystatin groups received topical treatment twice daily for 10 days. Then, we performed clinical and microbiological evaluations at baseline, day 5, and day 10. By the end of treatment, our results revealed that nanocurcumin promoted a significant reduction in the number of candida colonies. There was no statistically significant difference neither clinically nor microbiologically between nanocurcumin and nystatin groups. In conclusion, nanocurcumin has a good antifungal effect as nystatin, however, its therapeutic efficacy takes a longer time to appear than nystatin. The enhanced bioavailability of curcumin at the nanoscale qualifies this nano-herb as a promising alternative therapy for oral candidiasis, evading nystatin-associated morbidity.

Use of checkerboard assay to determine the synergy between essential oils extracted from leaves of Aegle marmelos (L.) Correa and nystatin against Candida albicans.

Background: Candida albicans is one of the most common pathogenic yeasts, responsible for causing candidiasis. The use of conventional antifungal agents for the treatment of Candida is reported to be less effective and hence alternative therapies for the treatment are needed. Essential oils of medicinal plants may serve as a strong candidate for natural products in modern therapies. Aim: The aim of this study was to determine the synergistic potential of essential oils extracted from leaves of Aegle marmelos (L.) Correa and a potent antifungal agent, nystatin, against three clinical isolates of C. albicans using checkerboard assay. Materials and methods: The antifungal activity of the essential oils of A. marmelos was screened against test cultures by disc diffusion technique. Antibiograms of the test organisms were developed. To determine the minimum fungicidal concentration of the essential oil and nystatin, the broth microdilution method was employed, and a checkerboard assay was used to investigate the synergistic potential of the essential oil and nystatin against the clinical isolates under study. The data were expressed as mean ± standard deviation. Results: The Σ fractional inhibitory concentration values were calculated as 0.12, 0.37, and 0.28 for three different strains of C. albicans used, respectively, which was <0.5, therefore, the synergy was demonstrated between essential oils and nystatin against the test cultures. Conclusions: Combinatorial therapy of the essential oils extracted from the leaves of A. marmelos and nystatin may be considered a line of treatment for candidal infections.

Inhibitory Effect of Standardized Extract and Fractions of Nigella sativa L. on Nystatin Susceptible and Clinically Nystatin Resistant Candida albicans.

INTRODUCTION: Candidiasis infection is caused by different species of Candida, which are characterized by host immunologic weakness. Black cumin seeds (Nigella sativa) have shown an inhibitory effect against Candida albicans. In this work, the inhibitory effect of standardized extract and different fractions of Nigella sativa seeds has been evaluated on both nystatin-susceptible and resistant strain of C. albicans. MATERIALS AND METHODS: Canadida albicans (NSCA) with ATCC 76645 and nystatin-resistant Candida albicans (NRCA) were prepared from oral samples of HIV individuals. Total extract and different fractions of N. sativa were prepared using maceration and sonication methods. Thymoquinone (TQ) content of the plant was determined by spectrophotometric method. Total extract (TTE) and the fractions along with TQ were evaluated on NSCA and NRCA by the microdilution method. RESULTS: TQ content of the plant was 0.92 ± 0.37g/100g dried extract. The least MIC and MFC (62.5 and 125 µg/ml, respectively) were due to petroleum ether fraction (PEF) against both NSCA and NRCA, followed by chloroform fraction (CHF) with MIC and MFC of 125 and 250 µg/ml, respectively. TQ exhibited MIC of 0.78 and 3.12 µg/ml against NSCA and NRCA, stronger than nystatin (MIC of 2 and 16 µg/ml, respectively). Thymoquinone was detected in the PEF and CHF. CONCLUSION: Considering more inhibitory effects of PEF and CHF than TTE, we can conclude that active components of the plant belong to non-polar compounds. PEF showed identical inhibitory effects on NRCA and NSCA, which is a valuable result for finding novel medicaments against NRCA infections.

Inhibitory effects of different fractions separated from standardized extract of Myrtus communis L. against nystatin-susceptible and nystatin-resistant Candida albicans isolated from HIV positive patients.

Background: and Purpose: Myrtle (Myrtus communis L.) is a medicinal herb that plays an essential role in treating fungal infections. The present study investigated the antifungal properties of different fractions of the M. communis L. leaf extract against Candida albicans (susceptible and resistant to nystatin). Materials and methods: Total extract (TE) and petroleum ether (PE), chloroform (CH), ethyl acetate (EA), and methanol (ME) fractions were prepared using the sonication method. The study used the standard strain sample (ATCC 76645) and nystatin-resistant C. albicans from oral samples of HIV-infected individuals. The identification of resistant isolate was performed using phenotypic and molecular methods. Minimum inhibitory concentration (MIC) and Minimum fungicidal concentration (MFC) of the fractions along total extract were determined by microdilution method on nystatin-resistant and susceptible Candida albicans. The Folin-Ciocalteu method was used to determine the total phenolic content of the extract. Results: The extraction yield (w/w) was 13.50 for TE, 2.10 for PE, 2.23 for Ch, 2.14 for EA, and 10.03 for ME fractions. Chloroform extract showed good anti-candida activity against nystatin susceptible and resistant C. albicans (62.5 â€‹µg/mL). Ethyl acetate fraction exhibited the greatest MIC against nystatin susceptible and resistant C. albicans (250 â€‹µg/mL). The MIC value of fluconazole was >64 µg/mL for both susceptible and -resistant strains. The amount of phenolic compounds of the total extract was reported to be equal to 5.4%, equivalent to gallic acid. Conclusion: Results revealed that the PE and CH fractions showed greater antifungal effects than the total extract against both susceptible and resistant strains of Candida albicans. It can conclude that active antifungal compounds of the plant belong to a specific group of metabolites, which according to the type of solvent, probably have non-polar nature. Further separation is carrying out.

Chitosan-Based Therapeutic Systems for Superficial Candidiasis Treatment. Synergetic Activity of Nystatin and Propolis.

The paper deals with new approaches to chitosan (CS)-based antifungal therapeutic formulations designed to fulfill the requirements of specific applications. Gel-like formulations were prepared by mixing CS dissolved in aqueous lactic acid (LA) solution with nystatin (NYS) powder and/or propolis (PRO) aqueous solution dispersed in glycerin, followed by water evaporation to yield flexible mesoporous (pore widths of 2-4 nm) films of high specific surfaces between 1 × 103 and 1.7 × 103 m2/g. Morphological evaluation of the antifungal films showed uniform dispersion and downsizing of NYS crystallites (with initial sizes up to 50 µm). Their mechanical properties were found to be close to those of soft tissues (Young's modulus values between 0.044-0.025 MPa). The films presented hydration capacities in physiological condition depending on their composition, i.e., higher for NYS-charged (628%), as compared with PRO loaded films (118-129%). All NYS charged films presented a quick release for the first 10 min followed by a progressive increase of the release efficiency at 48.6%, for the samples containing NYS alone and decreasing values with increasing amount of PRO to 45.9% and 42.8% after 5 h. By in vitro analysis, the hydrogels with acidic pH values around 3.8 were proven to be active against Candida albicans and Candida glabrata species. The time-killing assay performed during 24 h on Candida albicans in synthetic vagina-simulative medium showed that the hydrogel formulations containing both NYS and PRO presented the faster slowing down of the fungal growth, from colony-forming unit (CFU)/mL of 1.24 × 107 to CFU/mL < 10 (starting from the first 6 h).

Efficacy of Rose Bengal and Curcumin mediated photodynamic therapy for the treatment of denture stomatitis in patients with habitual cigarette smoking: A randomized controlled clinical trial.

BACKGROUND: Cigarette smoking in conjugation with bad oral hygiene is considered a typical predisposing factor for many oral diseases including denture stomatitis. This study investigated the effect of Rose Bengal (RB)-and Curcumin (CUR)-mediated photodynamic therapy (PDT) in comparison with nystatin therapy in the intervention of denture stomatitis in cigarette smokers. METHODS: Overall, 45 habitual cigarette smokers aged ~58 years having denture stomatitis were categorized into three groups: Group-I - RB-mediated PDT, Group-II - CUR-mediated PDT, and Group-III - Nystatin therapy. The primary outcome of the interest was: counts of Candida colony from denture surface and palatal mucosa, calculated as CFU/mL, whereas the prevalence of Candida species determined in 3 research groups comprised the secondary outcome. Oral swab specimens were gathered from the denture surfaces and palatal mucosa. All clinical assessments were performed at baseline, 6 weeks, and 12 weeks. RESULTS: C. albicans was the most prevalent yeast identified on both denture surfaces and palatal mucosa, followed by C. tropicalis and C. glabrata. A considerable decrease in the CFU/mL scores were observed in Group-I and Group-II at the end of the interventions and on the 12-week follow-up (p<0.05). Group-I, II, and III demonstrated clinical efficacy rates of 53%, 51%, and 49%, respectively. CONCLUSION: CUR-and RB-mediated PDT was found to be as effective as topical Nystatin therapy for the intervention of denture stomatitis among cigarette smokers.

In Vitro Antimicrobial and Cytotoxicity Activities of Some Medicinal Plant Extracts against Oral Microbial Pathogens.

INTRODUCTION: Medicinal plants have long been of great interest to scientists in the search for the best treatment of diseases, especially the infectious diseases. In recent years, the use of herbal medicines has become more well-known because of their antimicrobial, antifungal, anti-cancer and less side effects. AIM: The aim of this study was to investigate the antimicrobial and antifungal effects of Urtica dioica, Equisetum arvense, and Punica Granatum peel extracts on two common oral microorganisms, Streptococcus mutans and Candida albicans. MATERIALS AND METHODS: The study investigated the hydro-alcoholic extract of the plants. The antimicrobial activity of the extracts was evaluated using the method of measuring the inhibition of microorganisms, and the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) were determined using different concentrations of the extracts and also biofilm assay and SEM were determined. Also cell viability was assessed by MTT assay on human gingival fibroblast cells. RESULTS: The lowest MIC against S. mutants and C. albicans was related to the hydro-alcoholic extract of U. dioica. There was a significant reduction in the microbial biofilms by all three extracts. Among them, U. dioica could decrease the biofilms of S. mutans and C. albicans more than other extracts. In addition, the best results for growth inhibition zone were the hydro-alcoholic extracts of E. arvense and U. dioica with 35 and 30 mm growth zone, respectively. The results of SEM showed that P. granatum peel, U. dioica and E. arvense could destroy microbial biofilms without exerting any cytotoxic effects on HGF cell. CONCLUSIONS: The results of the study suggest that U. dioica, E. arvense, and P. Granatum peel extracts can be used as mouthwash with the least significant difference with routine mouthwashes. Also, the plant-based mouthwashes may be more suitable substitutes for chemical types in the future.

The comparison of the effect of curcumin with nystatin on inhibition level of Candida albicans.

BACKGROUND: Curcumin is a kind of medicinal plant, a member of the ginger family, Zingiberaceae. As the herbal medicine has been globally demanded in recent years and due to the anti-viral, anti-inflammatory, and antifungal properties of curcumin, the present study aimed to compare the inhibitory effect of curcumin with that of nystatin on Candida albicans growth. METHODS: In this experimental study, the antifungal effect of curcumin on Candida albicans was evaluated. Candida albicans is cultivated in Agar Sabuard medium containing chlorophenic, 10-series of curcumin extract, and one 10-series of a disc impregnated with nystatin. Inside of each plate, one disc of herbal extract, one disc of nystatin as a positive control, one disc of methanol and one empty disc as negative control were placed, after 24 hrs, the inhibitory zone diameter of the herbal extract was compared with that of positive control using Mann-Whitney. RESULTS: The mean of inhibitory zone diameter in nystatin and curcumin was 1.04±20.46 and 1.36±0.89 mm, respectively. Mann-Whitney test shows a significant difference between the inhibitory zone diameter of these materials (P<0.001). CONCLUSION: The results of this study suggested that curcumin extract did not have any effect on the inhibition of Candida albicans in laboratory environment.

The Antifungal Effects of Two Herbal Essences in Comparison with Nystatin on the Candida Strains Isolated from the Edentulous Patients.

AIM: The aim of this study is to evaluate the anticandidal effects of essential oils derived from fennel (Foeniculum vulgare) and cumin (Cuminum cyminum) on Candida strains isolated from edentulous patients. MATERIALS AND METHODS: Candida samples were isolated from 30 edentulous patients and the strains were identified using the CHROMagar method. Using the macro-broth dilution method and punched-hole tests, the effectiveness of fennel and cumin essential oils (prepared through distillation by water) was clarified. Nystatin was used as a positive control. RESULTS: Nystatin (44 µg/mL) had the strongest antifungal effect, followed by cumin [minimum inhibitory concentration (MIC) = 662 µg/mL; minimum fungicidal concentration (MFC) = 630 µg/mL] and fennel (MIC = 1,074 µg/mL; MFC = 1,227 µg/mL). The average diameter of the fungal growth inhibition zone was 23 mm for Nystatin, 14 mm for cumin essential oil, and 5 mm for fennel essential oil. CONCLUSION: The anti-Candida effects of fennel and cumin show promise as alternatives to conventional drugs for the treatment of Candida infections.

The effect of low level laser on number of Candida albicans colonies in-vitro: a new finding.

BACKGROUND: Candida albicans is a commensal organism that causes a wide variety of diseases in humans. One of these diseases is oral candidiasis, which occurs at a high recurrence rate in spite of available treatments. The purpose of this study was to compare the effect of low-level laser therapy (LLLT) with the use of nystatin on in-vitro growth of Candida albicans. METHOD: We prepared two samples of Candida albicans at different concentrations: 104 viable cells/ml and 106 viable cells/ml. Specimens from each sample were divided into a control group, a nystatin-treated group, and a group treated with LLLT. The control group was cultured without any intervention. The second group was treated with nystatin and the solution was vibrated for 30 s or 60 s. The third group was irradiated with a gallium-aluminum-argon (Ga-Al-Ar) diode laser (Epic 10; Biolase Inc.)in continuous mode using a wavelength of 940 nm and a power of 1 W for 30 s or 60 s (38 J/cm2 and 76 J/cm2). The specimens from the nystatin group and the LLLT group were cultured and the number of colony-forming units (CFU/ml) for each group was counted and compared. RESULTS: Nystatin completely eliminated the colonies (0 colonies) in all specimens. There was an increase in the number of colonies in the LLLT group for both cell concentrations at 30 s and at 60 s. However, this increase was statistically significant only for a concentration of 104 viable cells/ml at an exposure time of 30s. The increase in the concentration of 106 viable cells/ml at both 30 s and 60 s was statistically significant compared with the control group, although the highest number of colonies remained after an exposure time of 60s. CONCLUSION: LLLT led to an increase in the growth of Candida colonies. However, there was no significant difference related to the exposure time between the different cell concentrations.

Combination Therapy of Clinically Approved Antifungal Drugs Is Enhanced by Conjugation with Silver Nanoparticles.

Silver nanoparticles (SN) have been recently developed as a new class of antimicrobial agents against numerous pathogenic microorganisms. SN have also been used as efficient drug delivery systems and have been linked with increasing drug potency. Here, we demonstrated the enhanced antifungal efficacy of nystatin (NYT) and fluconazole (FLU) after conjugation with SN. The antifungal bioactivity of NYT- and FLU-coated SN was evaluated against Candida albicans ATCC 10231 and Aspergillus brasiliensis ATCC 16404 by the agar tube dilution method. The aim of this study was to determine and compare the antifungal efficacy of NYT and FLU with their SN and, finally, the combination of both nanoparticles as NYT-SN + FLU-SN against pathogenic fungi. The results indicated that all test samples showed a dose-dependent response against tested fungi. SN significantly enhanced the antifungal effects of NYT and FLU as compared to drugs alone. We observed a remarkable increase in the percent inhibition of both fungi (90-100%) when treated with a combination of both nanoparticles NYT-SN + FLU-SN at 200 µg/mL only. Furthermore, the morphological modifications occurred at the surface of fungal species were also analyzed by atomic force microscopy (AFM) and scanning electron microscopy (SEM). While tested against primary human cell line, all SN showed negligible cytotoxicity. Hence, these results suggest that the combination of SN with NYT and FLU may have clinical implications in the treatment of fungal infections. However, in vivo studies are needed before recommending the use of these nanoparticles safely in clinical situations.

Galleria mellonella as a model system to study virulence potential of mucormycetes and evaluation of antifungal treatment.

Mucorales can cause cutaneous to deep-seated infections, mainly in the immunocompromised host, resulting in high mortality rates due to late and inefficient treatment. In this study, Galleria mellonella larvae were evaluated as a heterologous invertebrate host to study pathogenicity of clinically relevant mucormycetes (Rhizopus spp., Rhizomucor spp., Lichtheimia spp., Mucor spp.). All tested species were able to infect G. mellonella larvae. Virulence potential was species-specific and correlated to clinical relevance. Survival of infected larvae was dependent on (a) the species (growth speed and spore size), (b) the infection dose, (c) the incubation temperature, (d) oxidative stress tolerance, and (e) iron availability in the growth medium. Moreover, we exploited the G. mellonella system to determine antifungal efficacy of liposomal amphotericin B, posaconazole, isavuconazole, and nystatin-intralipid. Outcome of in vivo treatment was strongly dependent upon the drug applied and the species tested. Nystatin-intralipid exhibited best activity against Mucorales, followed by posaconazole, while limited efficacy was seen for liposomal amphotericin B and isavuconazole. Pharmacokinetic properties of the tested antifungals within this alternative host system partly explain the limited treatment efficacy. In conclusion, G. mellonella represents a useful invertebrate infection model for studying virulence of mucormycetes, while evaluation of treatment response was limited.

Comparison of anti-Candida activities of the ancient plants Lawsonia inermis and Ziziphus spina christi with antifungal drugs in Candida species isolated from oral cavity.

CONTEXT: Medicinal plants have reportedly fewer side effects, compared to antifungal agents. AIMS: This study was designed to compare the anti-Candida activity of two medicinal plants with two routine antifungal agents, used in the clinics, on Candida species isolated from the oral cavity of the liver transplant patients. SUBJECTS AND METHODS: Anti-Candida activities of ethanol extracts of Lawsonia inermis leaf and Ziziphus spina christi unripe and ripe fruit (collected from south of Iran) versus nystatin and fluconazole were evaluated using CLSI M27-A3 standard method. RESULTS: The minimum inhibitory concentration (MIC) 90 values for L. inermis, Ziziphus spina christi ripe, and unripe fruits in Candida albicans were 0.1 µg/mL, 25 µg/mL, and 0.1 µg/mL, and in Candida glabrata were 0.05 µg/mL, 25 µg/mL, and 0.05 µg/mL, respectively. The MIC90 value for nystatin in both species was 0.035 µg/mL, but MIC90 value for fluconazole in C. albicans was 0.5 µg/mL and in C. glabrata was 2 µg/mL. CONCLUSION: Unripe fruits of Ziziphus spina christi and L. inermis were found more effective than fluconazole on Candida species. Ziziphus spina christi unripe fruit and L. inermis leaf have potential anti-Candida activity and can be considered as a new mouthwash agent to prevent and treat Candida infections. Further studies regarding pharmacokinetics and toxicities of these extracts are needed for their use in humans.

Necessity to identify the causative agent for appropriate treatment in fungal corneal ulcer: an in vitro study.

OBJECTIVE: Fungal corneal ulcers are a major cause of preventable blindness. Different antifungal agents as natamycin, nystatin, fluconazole, itraconazole, voriconazole are used to treat these ulcers. Among these, natamycin is most widely used as a treatment modality. In natamycin non-responding cases, other drugs especially voriconazole is used. This study was done to assess the use of antifungal drugs in the treatment of fungal corneal ulcer by determining the minimum inhibitory concentration against common fungal pathogens. MATERIAL AND METHODS: Minimum inhibitory concentration of fluconazole, itraconazole, voriconazole, nystatin and natamycin was assessed against the 61 isolated corneal fungal pathogens as per CLSI guidelines. RESULTS: MIC value of different antifungal agents varies as per fungal strains. Voriconazole showed the lowest MIC against the isolated fungi, in comparison to fluconazole and itraconazole. In comparison to other fungi, higher natamycin MIC was observed against Aspergillus species. Itraconazole is poorly effective against Fusarium sp. CONCLUSION: Identification of causative fungi is necessary before antifungal treatment. Lowest voriconazole MIC promotes its use as 1st line drug. Comparative higher natamycin MIC, especially against Aspergillus species, warns clinician to have MIC in each case of a non-responding fungal corneal ulcer.

Efficacy of Camellia sinensis extract against Candida species in patients with denture stomatitis.

BACKGROUND AND PURPOSE: Denture stomatitis is a chronic inflammation disease of the oral mucosa, which is specified by erythematous lesions mainly in the upper palate. Nystatin as a polyene, a class of antifungal agents, is one of the effective drugs to treat denture stomatitis. Considering the expansion of utilizing herbal drugs to cure many kinds of diseases, the present study was conducted to investigate the effects of Camellia sinensis (green tea), which has the most chemical and influence similarity with nystatin, against denture stomatitis. MATERIALS AND METHODS: This study was conducted on 22 patients with a positive mycological evidence for denture stomatitis caused by Candida species. The study population was divided into two groups, namely green tea and nystatin, receiving green tea mouthwash 0.5% and nystatin suspension 100,000 U/ml, respectively. The lesion size and number of yeast colonies were measured before and after the treatment. RESULTS: According to the results, both groups showed reduced lesion size, clinical improvement, and significant reduction of Candida colony count in both group of patients were showedafter the therapeutic. Based on the results of polymerase chain reaction, Candida albicans was the most common species isolated from denture stomatitis. There was no significant difference between the two study groups in terms of Candida species distribution (P =0.700). CONCLUSION: Green tea demonstrated a comparable anti-Candida activity with regard to nystatin; therefore, it could be recommended as an alternative treatment.

Antifungal effect of the bark and root extracts of Punica granatum on oral Candida isolates.

BACKGROUND AND PURPOSE: Oral candidiasis is one of the most common fungal infections in humans. The treatment and prophylaxis of the patients suffering from this infection require the identification of new anti-Candida agents with no side effects or toxicity like medicinal plants. The present study was conducted to compare the antifungal activities of the aqueous, ethanolic, and methanolic extracts of the bark and roots of P. granatum with those of two routine antifungal agents (i.e., fluconazole and nystatin) on oral Candida strains isolated from liver transplant recipients. MATERIALS AND METHODS: Minimum inhibitory concentrations (MICs) of the ethanolic, methanolic, and aqueous extracts of the bark and root of Punica granatum against C. albicans and C. glabrata isolated from oral cavities were evaluated according to the CLSI M27-A3. All data were analyzed in SPSS (version 16.0) by pairwise comparison and Kruskal-Wallis test. RESULTS: The MIC50 and MIC90 values for the methanolic and ethanolic extracts of the bark and root of P. granatum against C. albicans were both obtained as 0.05 mg/ml with the geometric mean (GM) of 0.07. Furthermore, the MIC90 values for the aqueous extracts of bark and root were estimated as 0.05 and 0.2 mg/ml, respectively. With regard to C. glabrata, the MIC50 and MIC90 values for the methanolic and ethanolic extracts of the bark and root were 0.05 mg/ml. However, the MIC90 value for the aqueous extract against this species was obtained as 25 mg/ml. The GM values for the aqueous extracts of the bark and root were 9.49 and 0.32, respectively. CONCLUSION: As the findings indicated, the methanolic and ethanolic extracts of the bark and root of Punica granatum had anti-Candida activities. Therefore, they can be considered as mouthwash or toothpaste to prevent and treat Candida infections in the oral cavity.

Current Trends in the Use of Two Combination Antifungal/Corticosteroid Creams.

Superficial fungal infections are among the most commonly managed skin problems by general practitioners. Although evidence shows combination antifungal/corticosteroid topicals are more expensive and less effective than single-agent antifungals, practitioners continue to prescribe combination agents. We examined current prescription trends of 2 combination antifungal/corticosteroid medications, Lotrisone and Mycolog-II.

Identification of multi-targeted anti-migraine potential of nystatin and development of its brain targeted chitosan nanoformulation.

The complex pathophysiology involved in migraine necessitates the drug treatment to act on several receptors simultaneously. The present investigation was an attempt to discover the unidentified anti-migraine activity of the already marketed drugs. Shared featured pharmacophore modeling was employed for this purpose on six target receptors (ß2 adrenoceptor, Dopamine D3, 5HT1B, TRPV1, iGluR5 kainate and CGRP), resulting in the generation of five shared featured pharmacophores, which were further subjected to virtual screening of the ligands obtained from Drugbank database. Molecular docking, performed on the obtained hit compounds from virtual screening, indicated nystatin to be the only active lead against the receptors iGluR5 kainate receptor (1VSO), CGRP (3N7R), ß2 adrenoceptor (3NYA) and Dopamine D3 (3PBL) with a high binding energy of -11.1, -10.9, -10.2 and -12kcal/mole respectively. The anti-migraine activity of nystatin was then adjudged by fabricating its brain targeted chitosan nanoparticles. Its brain targeting efficacy, analyzed qualitatively by confocal laser scanning microscopy, demonstrated a significant amount of drug reaching the brain. The pharmacodynamic models on Swiss male albino mice revealed significant anti-migraine activity of the nanoformulation. The present study reports for the first time the therapeutic potential of nystatin in migraine management, hence opening avenues for its future exploration.

Activity of the aqueous extract of Schinus terebinthifolius Raddi on strains of the Candida genus / Atividade do extrato aquoso de Schinus terebinthifolius Raddi sobre cepas do gênero Candida

ABSTRACT Objectives: To evaluate the antifungal susceptibility profile of the aqueous extract of the bark of Schinus terebinthifolius Raddi against the strains of the genus Candida. Methods: By using the disk diffusion method, 50 samples of the genus Candida (Candida albicans; Candida krusei; Candida glabrata; and Candida tropicalis), isolated from patients receiving treatment at Hospital Santa Casa de Misericórdia de São Paulo, and 1 American Type Culture Collection (ATCC) sample of each species were tested against: the isolated aqueous extract of the bark of Schinus terebinthifolius Raddi, isolated nystatin, and the association of nystatin and the aqueous extract of Schinus terebinthifolius Raddi. Results: There were no significant differences regarding the different strains of Candida tested. In the presence of the aqueous extract of Schinus terebinthifolius Raddi, no inhibition halo was visible. Isolated nystatin formed an inhibition halo measuring respectively 18.50 mm and 19.50 mm for the Candida albicans species and the others referred to as non-Candida albicans (Candida krusei; Candida glabrata; and Candida tropicalis). The association of nystatin and the aqueous extract of Schinus terebinthifolius Raddi resulted in inhibition halos measuring 14.25 mm and 16.50 mm respectively. The comparisons of these results are statistically significant (p < 0,001). Conclusion: The aqueous extract of Schinus terebinthifolius Raddi showed no antifun-gal activity in vitro against the strains tested, whereas the association of nystatin and the aqueous extract of Schinus terebinthifolius Raddi caused a decrease in the inhibition halo when compared with isolated nystatin.

RESUMO Objetivos: Avaliar o perfil de susceptibilidade antifúngica do extrato aquoso das cascas de Schinus terebinthifolius Raddi frente às cepas do gênero Candida. Métodos: Por meio do método de difusão em disco, 50 amostras do gênero Candida (Candida albicans, Candida krusei, Candida glabrata e Candida tropicalis) provenientes de pacientes do Hospital da Santa Casa de Misericórdia de São Paulo, e 1 amostra American Type Culture Collection (ATCC) de cada espécie foram testadas frente ao extrato aquoso das cascas de Schinus terebinthifolius Raddi isolado, nistatina isolada, e a associação da nistatina ao extrato aquoso de Schinus terebinthifolius Raddi. Resultados: Não houve diferenças significantes em relação às diferentes espécies de cepas de Candida testadas. O extrato aquoso de Schinus terebinthifolius Raddi não formou halo de inibição. A nistatina isolada formou halo de inibição de 18,50 mm e 19,50 mm respectivamente para as espécies Candida albicans e as demais nomeadas como não Candida albicans (Candida krusei, Candida glabrata e Candida tropicalis). A associação da nistatina ao extrato aquoso de Schinus terebinthifolius Raddi resultou no halo de inibição de 14,25 mm e 16,50 mm respectivamente, sendo que as comparações destes resultados são estatisticamente significantes (p < 0,001). Conclusão: O extrato aquoso de Schinus terebinthifolius Raddi não demonstrou propriedade antifúngica in vitro frente às cepas testadas, e a associação da nistatina ao extrato aquoso de Schinus terebinthifolius Raddi causou a diminuição do halo de inibição quando comparado à nistatina isolada.