In vitro antifungal activity of allicin alone and in combination with two medications against Trichophyton rubrum

Antifungal Combinations in Dermatophytes

Dermatophytes are the most common cause of fungal infections worldwide, affecting millions of people annually. The emergence of resistance among dermatophytes along with the availability of antifungal susceptibility procedures suitable for testing antifungal agents against this group of fungi make the combinatorial approach particularly interesting to be investigated. Therefore, we reviewed the scientific literature concerning the antifungal combinations against dermatophytes. A literature search on the subject performed in PubMed yielded 68 publications: 37 articles referring to in vitro studies and 31 articles referring to case reports or clinical studies. In vitro studies involved over 400 clinical isolates of dermatophytes (69% Trichophyton spp., 29% Microsporum spp., and 2% Epidermophyton floccosum). Combinations included two antifungal agents or an antifungal agent plus another chemical compound including plant extracts or essential oils, calcineurin inhibitors, peptides, disinfectant agents, and others. In general, drug combinations yielded variable results spanning from synergism to indifference. Antagonism was rarely seen. In over 700 patients with documented dermatophyte infections, an antifungal combination approach could be evaluated. The most frequent combination included a systemic antifungal agent administered orally (i.e., terbinafine, griseofulvin, or azole-mainly itraconazole) plus a topical medication (i.e., azole, terbinafine, ciclopirox, amorolfine) for several weeks. Clinical results indicate that association of antifungal agents is effective, and it might be useful to accelerate the clinical and microbiological healing of a superficial infection. Antifungal combinations in dermatophytes have gained considerable scientific interest over the years and, in consideration of the interesting results available so far, it is desirable to continue the research in this field.

In vivo anti-Trichophyton Activities of Seed Oil Obtained from Caraganakorshinskii Kom

AIM

The objective of this study was to evaluate the effects of seed oil of Caragana korshinskii Kom. against Trichophyton mentagrophytes on an in vivo guinea pig model of dermatophytosis.

METHODS

The skin of albino guinea pigs was infected with T. mentagrophytes, and the animals were divided into five groups: negative control (NC group), positive control (PC group), vehicle control, CK50% group (received topical 50% seed oil of C.korshinskii), and CK100% group (received topical 100% seed oil of C.korshinskii). Evaluation of clinical efficacy was performed 72 h after the completion of a 10-day treatment regimen. Skin biopsy samples were processed for histopathological examination.

RESULTS

The infected untreated control guinea pigs showed patches of hair loss and ulcerated or scaly skin. Lower clinical scores indicate improved efficacy compared with NC. The lesion scores significantly declined in the CK50%, CK100%, and PC groups in comparison with the NC group. The CK50% group (45.31%) and the CK100% group (75%) showed clinical efficacy compared with the PC group (78.13%). In addition, no fungal elements, inflammation, or tissue destruction was observed in any of the PAS-stained sections of the infected skin in the groups treated with CK100% or 1% terbinafine.

CONCLUSION

Seed oil of C.korshinskii demonstrated high antifungal efficacy in experimental dermatophytosis.