Synergism between fluconazole and methylene blue-photodynamic therapy against fluconazole-resistant Candida strains

Abstract

Photodynamic therapy (PDT) has been proved to be effective against fungi and it may be employed as a coadjutant to conventional antifungal agents, leading to a more effective microbial control minimising side effects. This work evaluates the combined effect of PDT and fluconazole against resistant Candida albicans, Candida glabrata and Candida krusei. The yeasts were submitted to methylene blue-PDT (MB-PDT) in sub-inhibitory concentrations. In the present work, MB-PDT combined with fluconazole was more efficient in the inhibition of the C. albicans and C. glabrata than each treatment alone, being possible to infer that the treatments are synergic.

Photodynamic Therapy Combined with Antibiotics or Antifungals against Microorganisms That Cause Skin and Soft Tissue Infections: A Planktonic and Biofilm Approach to Overcome Resistances

“…A synergistic combination effect against the strains of C. albicans and C. glabrata , but not against C. krusei , was found. The effect of MB-aPDT alone against C. krusei was not statistically significant compared to the effect of its combination with fluconazole [ 61 ].…”

Antimicrobial efficacy of photodynamic therapy on the treatment of oral candidiasis in people living with hiv/aids

“…An experimental study with 21 PLWHA showed that fluconazole did not prevent recurrence of oral candidiasis when they were reevaluated within 30 days, whereas in patients receiving PDT, there was no recurrence of the lesion during the same reevaluation period 14 . The combination of PDT and fluconazole was effective in reducing C. albicans colonies in in vitro 10,11 and in vivo 12,13 studies. In this study, participants 015 and 018, respectively, received PDT/nystatin and PDT/ fluconazole exhibited a reduction in oral candidiasis severity ratings when reassessed after 14 days.…”

“…This technique has shown to be promising in reducing C. albicans colonies in in vitro [9][10][11] and in vivo 12,13 assays. PDT was also effective in the treatment of oral candidiasis in PLWHA, without causing side effects, both isolated 14 and when associated with topical antifungals 15 .…”

A combination of photodynamic therapy and antimicrobial compounds to treat skin and mucosal infections: a systematic review

“…The former demonstrated that both planktonic suspensions and biofilms were much more susceptible to antifungal drug treatments after MB-aPDT, which may be due to an increase in membrane permeability by the aPDT 27 . They later evaluated in vitro the combination of MB-aPDT and fluconazole against fluconazole-resistant C. albicans strains, and reported a synergistic effect 28 .…”