title: In vitro synergism of fluconazole and baicalein against clinical isolates of Candida albicans resistant to fluconazole.
abstract: In vitro interaction of fluconazole and baicalein (BE) was investigated against 30 fluconazole-resistant clinical isolates of Candida albicans. Synergistic activities were determined using the checkerboard microdilution assay based on the fractional inhibitory concentration indices. Organisms were also tested against the 2 drugs singly and in combination using time-kill methods. Both fluconazole and BE showed weak antifungal activity when tested alone. However, the combination of fluconazole and BE showed strong antifungal activity against most of the fluconazole-resistant isolates tested. The findings of time-kill curves confirmed the interaction. Yeast cells grown in the presence of BE exhibited a reduced extrusion of Rhodamine 6G, which indicates the inhibition of efflux pumps by BE. This novel synergism of fluconazole and BE that can overcome drug-resistance in yeast may prove useful in combined treatment of fungal infections.
authors.affiliation: School of Pharmacy, Second Military Medical University, Shanghai 200433, PR China.
authors.forename: Shan
authors.initials: S
authors.lastname: Huang
authors.forename: Ying Ying
authors.initials: YY
authors.lastname: Cao
authors.forename: Bao Di
authors.initials: BD
authors.lastname: Dai
authors.forename: Xuan Rong
authors.initials: XR
authors.lastname: Sun
authors.forename: Zhen Yu
authors.initials: ZY
authors.lastname: Zhu
authors.forename: Yong Bing
authors.initials: YB
authors.lastname: Cao
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Ping Hui
authors.initials: PH
authors.lastname: Gao
authors.forename: Yuan Ying
authors.initials: YY
authors.lastname: Jiang
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D002176:Candida albicans / Q000187:drug effects*; D002177:Candidiasis / Q000382:microbiology; D025141:Drug Resistance, Fungal / Q000187:drug effects*; D044950:Flavanones / Q000494:pharmacology*; D015725:Fluconazole / Q000494:pharmacology*; D005456:Fluorescent Dyes; D005947:Glucose / Q000494:pharmacology; D007700:Kinetics; D008826:Microbial Sensitivity Tests; D012235:Rhodamines
chemical_list: D000935:Antifungal Agents; D044950:Flavanones; D005456:Fluorescent Dyes; D012235:Rhodamines; C026188:rhodamine 6G; C006680:baicalein; D015725:Fluconazole; D005947:Glucose