In vitro antifungal activity of Clotrimazole, Miconazole and Ketoconazol by binary mixture pattern against hospital isolates of Candida

The lack of variation in antifungal drugs, and the misuse or inappropriate use usually causes resistant strains of the yeast in human’s normal flora. Unfortunately, a large number of Candida infection cases in immunosuppressed patients with insufficient treatment eventually can cause patient's death. The aim of this study was to evaluate the in vitro conventional antifungal azole compounds with binary mixture with appropriate ratios by susceptibility test using the laboratory as a mixture of two in vitro conditions. In present study, 10 isolates of Candida were admitted from patients that were referred to mycology laboratory of Faghihi Hospital at Shiraz with signs of cutaneous and mucosal infections. In the present study we used the methods of the binary mixure of common antifungal drugs Clotrimazole, Ketoconazole and Miconazole on equally proportion have been used. The drugs were solved in various concentrations on the SDA medium and then Cndida isolates were cultured in the SDA plates. The minimum inhibitory concentration (MIC 90) and minimum fungicidal concentration (MFC) was determined. The results of this study suggest that a binary mixture of these drugs inhibited the growth of most strains of pathogenic Cndida isolates. The combination with Clotrimazole and ketoconazole in equal proportion had more effective than other drug mixtures against all isolates with the exception of isolate 3. In contrary, the combination of Miconazole and Clotrimazole had the least effect, and the MIC was calculated in the range of 3.12 to 50 μg/ml. Evaluation of MFC showed almost the same results. Lowest values of the MFC belonged to the combination of clotrimazole and ketoconazole which was obtained 6.25 μg/ml. It is concluded that the use of the combination of Clotrimazole and Ketoconazole in equal ratios has better antifungal effects against cutaneous and mucosal isolates of the Candida infection.