SYNERGYSTIC ANTIFUNGAL EFFECT OF FLUCONAZOLE COMBINED WITH CYMBOPOGON CITRATUS ESSENTIAL OIL AGAINST CANDIDA ALBICANS
DOI:
https://doi.org/10.25170/djm.v20i2.2513Keywords:
Candida albicans, Cymbopogon citratus, Fluconazole, SynergisticAbstract
Introduction: Candida albicans is a common human flora. However, if the amount is above average, it can cause a disease called candidiasis. Fluconazole is an antifungal medication that can cure candidiasis but its number of resistance is increasing. Therefore alternative treatments are needed like using herbs. Cymbopogon citratus essential oil is proven to have an antifungal effect. The purpose of this study is to see the synergistic antifungal effect of fluconazole combined with lemongrass against C. albicans.
Methods: Experimental study design was used in this research and conducted in vitro. C. citratus was extracted with hydrodistillation method. Disc diffusion method was performed using MHA agar with Glucose 2% and methylene blue. Lemongrass essential oil concentration that are used are 2,5%, 5%, 10%, and 20% using tween as a solvent.
Results: Minimum concentration of lemongrass essential oil that could inhibit C. albicans growth is 10% with average diameter of inhibition zone 10 mm. Minimum concentration of fluconazole combined with lemongrass essential oil that could inhibit C. albicans growth is 2,5% with average diameter 21,3333 mm. Average diameter of inhibition zone by fluconazole combined with lemongrass essential oil is greater than fluconazole’s inhibition zone added with lemongrass essential oil inhibition zone alone, therefore fluconazole combined with C. citratus essential oil work synergistically.
Conclusion: There is a synergistic antifungal effect of fluconazole combined with C. citratus essential oil against C. albicans.
Key Words: Candida albicans, Cymbopogon citratus, fluconazole, synergistic
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References
2. CDC. Candidiasis [Internet]. 2019 [cited 2019 Oct 29]. Available from: https://www.cdc.gov/fungal/disease/candidiasis/index.html
3. Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis Off Publ Infect Dis Soc Am. 2016;62(4):e1–50.
4. Berkow EL, Lockhart SR. Fluconazole resistance in Candida species: a current perspective. Infect Drug Resist. 2017;10:237–45.
5. Bongomin F, Gago S, Oladele RO, Denning DW. Global and Multi-National Prevalence of Fungal Diseases—Estimate Precision. J Fungi [Internet]. 2017 [cited 2019 Oct 29];3(4). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5753159/
6. Hoofnagle J. Fluconazole. In: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012 [cited 2019 Nov 19]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK548300/
7. Shah G, Shri R, Panchal V, Sharma N, Singh B, Mann AS. Scientific basis for the therapeutic use of Cymbopogon citratus, stapf (Lemon grass). J Adv Pharm Technol Res. 2011;2(1):3–8.
8. Kusriawati D. Uji Efektivitas Distilasi Uap Minyak Atsiri Serai Dapur (Cymbopogon citratus) Sebagai Antifungi Terhadap Candida albicans Secara in vitro dengan Metode Difusi Cakram. Univ Brawijaya [Internet]. 2014; Available from: http://repository.ub.ac.id/124440/
9. Pandurang M, Devrao H, Ganpatrao B, Mohan K. Lemongrass Oil Components Synergistically Activates Fluconazole against Biofilm Forms of Candida albicans. J Bacteriol Mycol. 2018;8.
10. Boonyanugomol W, Kraisriwattana K, Rukseree K, Boonsam K, Narachai P. In vitro synergistic antibacterial activity of essential oil from Zingiber cassumunar Roxb against extensively drug-resistant Acinetobacter baumanii strains. J Infect Public Health. 2017.
11. Slamet, Supiyanto, Riyanto. Studi Perbandingan Perlakuan Bahan Baku dan Metode Distilasi Terhadap Rendemen dan Kualitas Minyak Atsiri Sereh Dapur (Cymbopogon citratus). J Online Univ Gajah Mada. 2013.
12. Abe S, Sato Y, Inoue S, Ishibashi H, Maruyama N, Takizawa T, et al. Anti-Candida albicans activity of essential oils including Lemongrass (Cymbopogon citratus) oil and its component, citral. Nihon Ishinkin Gakkai Zasshi Jpn J Med Mycol. 2003;44(4):285–91.
13. Afrina, Nasution A, Rahmania N. Konsentrasi Hambat dan Bunuh Minimum Ekstrak Serai (Cymbopogon citratus) Terhadap Candida albicans. Cakradonya Dent J. 2017.
14. Zhang Q-W, Lin L-G, Ye W-C. Techniques for extraction and isolation of natural products: a comprehensive review. Chin Med [Internet]. 2018 [cited 2020 Jan 1];13. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5905184/
15. Salma, Yunus M. An analysis and comparison of two essential oils extraction methodologies for lemongrass (Cymbopogon citratus (DC.) Stapf). Univ Malays Perlis. 2013.
16. Khan MSA, Ahmad I. In vitro antifungal activity of oil of Cymbopogon citratus and citral alone and in combination with flluconazole against azole-resistant strains of Aspergillus fumigatus and Trichophyton rubrum. Pharmacogn J. 2013;3(3):6.
17. Ahmad I, Owais M, Shadid M, Aqil F. Combinational antifungal therapy and recent trends in drug discovery. Springer Verl. 2010;213–40.
18. Kumar R, Shrivastava SK, Chakraborti A. Comparison of Broth Dilution and Disc Diffusion Method for the Antifungal Susceptibility Testing of Aspergillus flavus. Am J Biomed Sci. 2010;2
