interactions of nystatin and micafungin combined with chlorhexidine against isolates.

BACKGROUND AND PURPOSE

Oral candidiasis has become a growing problem in hospitals worldwide, and the development of antifungal drug resistance in species constitutes a serious concern. This study aimed to evaluate the efficacy of nystatin, and micafungin with chlorhexidine against fluconazole-resistant and fluconazole-sensitive () isolates.

MATERIALS AND METHODS

In this experimental-laboratory study, a total of 20 fluconazole-resistant (n=10) and fluconazole-susceptible (n=10) strains were obtained from the reference culture collection of the Invasive Fungi Research Center in Mazandaran University of Medical Sciences, Sari, Iran. combination of nystatin and micafungin with chlorhexidine was performed using a microdilution checkerboard method based on the Clinical and Laboratory Standards Institute guideline.

RESULTS

Micafungin had the highest antifungal activity against susceptible and resistant strains, with a Geometric mean of (GM) =0.008µg/ml and GM=0.008µg/ml, followed by nystatin with GM=0.06µg/ml and GM=0.042µg/ml and chlorhexidine with GM=0.25µg/ml and GM=0.165µg/ml against resistant and sensitive strains, respectively. The interaction of micafungin and nystatin with chlorhexidine showed a synergistic interaction against most strains. In addition, no antagonistic interaction was observed between micafungin, nystatin, and chlorhexidine against strains.

CONCLUSION

The synergistic interaction of micafungin with chlorhexidine against azole-resistant suggests an alternative approach to overcome antifungal drug resistance. However, further studies are needed for evaluation.