Indifferent effect of nonsteroidal anti-inflammatory drugs (NSAIDs) combined with fluconazole against multidrugresistant Candida auris

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AHANGARKANI FATEMEH; KHODAVAISY SADEGH; MAHMOUDI SHAHRAM; SHOKOHI TAHEREH; REZAI MOHAMMAD SADEGH; Fakhim Hamed; Dannaoui Eric; Faraji Saharnaz; CHOWDHARY ANURADHA; MEIS JACQUES F.; BADALI HAMID

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Journal: CURRENT MEDICAL MYCOLOGY Year:2019 | Volume:5 | Issue:3 Page(s): 26-30

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Title

Indifferent effect of nonsteroidal anti-inflammatory drugs (NSAIDs) combined with fluconazole against multidrugresistant Candida auris

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Keywords

Antifungal drugs

Candida auris

Multidrug-resistant

NSAIDs

Abstract

Background and Purpose: Emergence and development of antifungal drug resistance in Candida species constitute a serious concern. Candida auris as an emerging multidrug-resistant fungus is the most important public health threat with high levels of mortality and morbidity. Almost all C. auris isolates are resistant to fluconazole, and there have been reports of elevated minimum inhibitory concentrations (MICs) to amphotericin B and echinocandins. To overcome the growing challenge of antifungal resistance, a valuable alternative option would be the use of drug combination. Materials and Methods: The present study evaluated the in vitro combination of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac and aspirin with fluconazole against fluconazole-resistant C. auris in comparison to other fluconazole-resistant Candida species, including C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, and C. krusei originating from patients with candidiasis. Results: The MIC ranges of fluconazole-ibuprofen and fluconazole-diclofenac decreased from 32-256 to 32-128 and 16-256 µ g/ml, respectively and remained the same for fluconazole-aspirin against C. auris. However, the combination of fluconazole with ibuprofen resulted in a synergistic effect for 5 strains, including C. albicans (n=2), C. tropicalis (n=1), C. glabrata (n=1), and C. krusei (n=1), by decreasing the MIC of fluconazole by 2-3 log2 dilutions. Conclusion: Although the interaction of NSAIDs with fluconazole was not synergistic against fluconazole-resistant C. auris isolates, no antagonism was observed for any combinations. Therefore, combination with newer azole agents needs to be conducted.

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APA: Copy

AHANGARKANI, FATEMEH, KHODAVAISY, SADEGH, MAHMOUDI, SHAHRAM, SHOKOHI, TAHEREH, REZAI, MOHAMMAD SADEGH, Fakhim, Hamed, Dannaoui, Eric, Faraji, Saharnaz, CHOWDHARY, ANURADHA, MEIS, JACQUES F., & BADALI, HAMID. (2019). Indifferent effect of nonsteroidal anti-inflammatory drugs (NSAIDs) combined with fluconazole against multidrugresistant Candida auris. CURRENT MEDICAL MYCOLOGY, 5(3), 26-30. SID. https://sid.ir/paper/767500/en

Vancouver: Copy

AHANGARKANI FATEMEH, KHODAVAISY SADEGH, MAHMOUDI SHAHRAM, SHOKOHI TAHEREH, REZAI MOHAMMAD SADEGH, Fakhim Hamed, Dannaoui Eric, Faraji Saharnaz, CHOWDHARY ANURADHA, MEIS JACQUES F., BADALI HAMID. Indifferent effect of nonsteroidal anti-inflammatory drugs (NSAIDs) combined with fluconazole against multidrugresistant Candida auris. CURRENT MEDICAL MYCOLOGY[Internet]. 2019;5(3):26-30. Available from: https://sid.ir/paper/767500/en

IEEE: Copy

FATEMEH AHANGARKANI, SADEGH KHODAVAISY, SHAHRAM MAHMOUDI, TAHEREH SHOKOHI, MOHAMMAD SADEGH REZAI, Hamed Fakhim, Eric Dannaoui, Saharnaz Faraji, ANURADHA CHOWDHARY, JACQUES F. MEIS, and HAMID BADALI, “Indifferent effect of nonsteroidal anti-inflammatory drugs (NSAIDs) combined with fluconazole against multidrugresistant Candida auris,” CURRENT MEDICAL MYCOLOGY, vol. 5, no. 3, pp. 26–30, 2019, [Online]. Available: https://sid.ir/paper/767500/en

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