Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Synergistic antifungal activity of combinations of Artemisia annua extract with fluconazole against resistant strains of Candida albicans

Maria I Ngwu¹, Godwin I Ngwu² , Chibundo N Okorie¹, Stephen C Emencheta¹, Damian C Odimegwu¹, Anthony A Attama³, Emmanuel C Ibezim³

¹Department of Pharmaceutical Microbiology and Biotechnology, University of Nigeria, Nsukka, Enugu State, Nigeria; ²Department of Zoology and Environmental Biology, University of Nigeria, Nsukka, Enugu State, Nigeria; ³Department of Pharmaceutics, University of Nigeria, Nsukka, Enugu State, Nigeria.

For correspondence:- Godwin Ngwu Email: godwin.ngwu@unn.edu.ng

Accepted: 2 June 2024 Published: 29 June 2024

Citation: Ngwu MI, Ngwu GI, Okorie CN, Emencheta SC, Odimegwu DC, Attama AA, et al. Synergistic antifungal activity of combinations of Artemisia annua extract with fluconazole against resistant strains of Candida albicans. Trop J Pharm Res 2024; 23(6):941-949 doi: 10.4314/tjpr.v23i6.4

© 2024 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To elucidate how fluconazole and the methanol extract of Artemisia annua interact to inhibit the growth of fungi.

Methods: Five hundred clinical samples of Candida albicans were isolated from patients attending three tertiary health facilities in Enugu State, Nigeria, namely, University of Nigeria Teaching Hospital (UNTH), Ituku Ozala, Bishop Shanahan Hospital (BSH), Nsukka, and Enugu State University Teaching Hospital (ESUTH), Enugu. Out of the five hundred clinical samples collected, eight genetically proven C. albicans isolates were employed for this study. The synergy between Artemisia annua and fluconazole was characterized by checkerboard analyses and fractional inhibitory concentration indices (FIC).

Results: Minimum inhibitory concentration (MIC) testing results show that most isolates were resistant to selected azoles employed in the study. Based on fractional inhibitory concentration (FIC) index, specific mixtures of the extract and FLU had synergistic effects on isolates of resistant Candida albicans.

Conclusion: When combined with fluconazole, the extract of A. annua demonstrated better inhibition than fluconazole alone against resistant C. albicans. This suggests a promising strategy for tackling the challenge of emerging fungal antibiotic resistance.

Keywords: Candidiasis, Azole, Fluconazole, Artemisia annua, Synergy, Checkerboard