Synergistic effects of ketamine and azole derivatives on spp. resistance to fluconazole.

The emergence of spp. with resistance to antifungal molecules, mainly the azole class, is an increasing complication in hospitals around the globe. In the present research, we evaluated the synergistic effects of ketamine with two azole derivatives, itraconazole and fluconazole, on strains of spp. to fluconazole. The drug synergy was evaluated by quantifying the fractional inhibitory concentration index and by fluorescence microscopy and flow cytometry techniques. Our achievements showed a synergistic effect between ketamine in addition to the two antifungal agents (fluconazole and itraconazole) against planktonic cells and biofilms of spp. This combination promoted alteration of membrane integrity, generation of reactive oxygen species, damage to and DNA and externalization of phosphatidylserine.