Synergistic activity between Echinophora platyloba DC ethanolic extract and azole drugs against clinical isolates of Candida albicans from women suffering chronic recurrent vaginitis

Abstract

Objective: Candida albicans is one of the main causes of vaginitis, especially in women with recurrent episodes. The appearance of drug resistant C. albicans and adverse effects of chemical agents have raised interest in Echinophora platyloba as one of four native species in Traditional Persian-Iranian medicine.

Materials and methods: This study evaluates the antifungal activity of ethanolic extract from dried aerial parts of E. platyloba against 27 clinical isolates of C. albicans from women suffering chronic recurrent vaginitis by micro-broth dilution assay. The synergistic effect of azole drugs and E. platyloba ethanolic extract were also determined by disc diffusion method after determining the MIC90.

Results: The results of this study showed a potent synergistic effect of E. platyloba ethanolic extract and itraconazole (P<0.01) and fluconazole (P<0.001) but an antagonistic effect between E. platyloba ethanolic extract and clotrimazole and miconazole against clinical isolates of C. albicans.

Conclusion: These results must be confirmed by clinical application and by further clinical studies.

Keywords: Agents azolés; Azole agents; Candida albicans; Echinophora platyloba; Ethanolic extract; Extrait à l’éthanol; Médecine traditionnelle iranienne; Médecine traditionnelle persane-iranienne; Recurrent vulvo-vaginal candidiasis; Traditional Iranian medicine; Traditional Persian-Iranian medicine; Vaginite récidivante.