The Synergistic Activity of Fluconazole (FLC) Resistance to Candida albicans with Quercetin (QRT)

Background & Objective: Fluconazole (FLC) is one of the best widely used antifungal medications for Candidiasis, which is one of the most prevalent fungal illnesses affecting women. FLC is fungistatic rather than fungicidal; hence, medication in the presence of this antifungal allows acquired resistance to develop, can be traced to the overuse of these treatments in a highly linked global population recently. To the best of our knowledge, this was the first study assessed the synergistic activity of FLC in combination with quercetin (QRT) against fluconazole-resistant Candida albicans responsible for VVC in vivo and vitro.Materials & Methods: This study was conducted in Basrah city, Iraq, between 10th August and 20th November 2023, and involved 100 vaginal swabs collected from women, who were suffering from past vaginitis and its symptoms or not, taken with sterile cotton swabs and 24-hour media exchanges. For the diagnosis, swab samples were collected, packaged, and sent to the microbiology laboratories for culturing on various media.Results: The distribution between past vaginitis and symptoms of infections (discharge, smell, and redness) were significant with p-values (0.02, 0.01, and 0.02, respectively), while it was not significantly itching, with p-value (0.2). Out of the (100) specimens collected in this study, (75%) had grown on the media, only (50) of those specimens had Candida albicans growth, and only 30 (60%) of them had fluconazole-resistant Candida albicans and these isolates considered as the study population. The combination of FLC with QRT was partially synergic, with FICI=1.Conclusion: These findings indicate QRT may be encouraging antifungal agents in combination with FLC in managing C. albicans infections.