In-vitro synergistic effect of fluconazole with nonsteroidal anti-inflammatory agents against Candida albicans strains

The in-vitro interaction and synergistic activity of the combination of flu conazole with some nonsteroidal anti-inflammatory drugs (sodium salicylate, piroxicam, tenoxicam and diclofenac sodium) were investigated in Candida a lbicans strains (n = 7) by the microdilution checkerboard assay. The result s were evaluated visually and by a spectrophotometric microplate reader at 492 nm wavelength. Fractional inhibitory index was calculated for every str ain and combination according to the minimal inhibitory concentration (MICs ). The combination of fluconazole with sodium salicylate, tenoxicam and dic lofenac sodium showed synergy against 5, 5 and 3 of the C. albicans strains , respectively. The effect of fluconazole with piroxicam was synergistic ag ainst one strain but indifferent/additive against the others. These data su ggest that combinations of sodium salicylate, tenoxicam and diclofenac sodi um with fluconazole may prove to be useful as chemotherapeutic agents for t he treatment of C. albicans infections caused by especially fluconazole-res istant strains. However, additional preclinical work and in vivo studies ar e necessary to determine their definite clinical use.