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A novel use for an old drug: resistance reversal in Candida albicans by combining dihydroartemisinin with fluconazole.

Hui Li,Haisheng Chen,Wenna Shi,Jing Shi,Jupeng Yuan,Cunxian Duan,Qing Fan,Yuguo Liu

Published 2021 in Future Microbiology

ABSTRACT

Aim: To investigate the effects of dihydroartemisinin combined with fluconazole against C. albicans in vitro and to explore the underlying mechanisms. Materials & methods: Checkerboard microdilution assay and time-kill curve method were employed to evaluate the static and dynamic antifungal effects against C. albicans. Reactive oxygen species (ROS) was measured by a fluorescent probe. Results: Combination of dihydroartemisinin and fluconazole exerted potent synergy against planktonic cells and biofilms of fluconazole-resistant C. albicans, with the fractional inhibitory concentration index values less than 0.07. A potent fungistatic activity of this drug combination could still be observed after 18 h. The accumulation of ROS induced by the drug combination might contribute to the synergy. Conclusion: Dihydroartemisinin reversed the resistance of C. albicans to fluconazole.

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