title: In vitro evaluation of the acquisition of resistance, antifungal activity and synergism of Brazilian red propolis with antifungal drugs on Candida spp.
abstract: OBJECTIVE
  To evaluate the ability of Candida parapsilosis and Candida glabrata to develop phenotypic resistance to a benzophenone enriched fraction obtained from Brazilian red propolis (BZP-BRP) as compared to fluconazole (FLC). To investigate possible synergy between BZP-BRP and FLC and anidulafungin (AND).
  
  
  RESULTS
  To analyse the development of resistance, isolates susceptible to these antifungals were cultured in increasing concentrations of FLC and BZP-BRP. The increase in FLC minimum inhibitory concentration for all isolates was evident and the majority developed resistance, whereas none isolated became less susceptible to BZP-BRP. Synergism was investigated by checkerboard method. BZP-BRP demonstrated synergy with FLC and indifference with AND for most isolates.
  
  
  CONCLUSIONS
  In conclusion, the synergism observed with FLC suggests that BZP-BRP could be a possible therapeutic strategy for the treatment of infections related to FLC-resistant Candida sp.
  
  
  CONCLUSIONS
  The indiscriminate use of antifungals results in the emergence of drug-resistant strains among previously susceptible populations. BZP-BRP can become an alternative for the treatment of persistent infections caused by Candida sp.
authors.affiliation: Programa de Pós Graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: B
authors.initials: B
authors.lastname: Pippi
authors.forename: A J D
authors.initials: AJ
authors.lastname: Lana
authors.forename: R C
authors.initials: RC
authors.lastname: Moraes
authors.forename: C M
authors.initials: CM
authors.lastname: Güez
authors.forename: M
authors.initials: M
authors.lastname: Machado
authors.forename: L F S
authors.initials: LF
authors.lastname: de Oliveira
authors.forename: G
authors.initials: G
authors.lastname: Lino von Poser
authors.forename: A M
authors.initials: AM
authors.lastname: Fuentefria
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology*; D001938:Brazil; D002175:Candida / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000378:metabolism; D025141:Drug Resistance, Fungal; D004357:Drug Synergism; D015725:Fluconazole / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D010936:Plant Extracts / Q000494:pharmacology*; D011429:Propolis / Q000737:chemistry*
chemical_list: D000935:Antifungal Agents; D010936:Plant Extracts; D015725:Fluconazole; D011429:Propolis
keywords: Brazilian red propolis; Candida; antifungal agent; fluconazole; resistance; synergism