Synergistic Anticandidal Activity of Etomidate and Azoles Against Clinical Fluconazole-Resistant<i>Candida</i>Isolates

Abstract

<b>Aim:</b> The purpose of this study was to evaluate the effect of etomidate alone and in combination with azoles on resistant strains of <i>Candida</i> spp. in both planktonic cells and biofilms. <b>Materials & methods:</b> The antifungal activity of etomidate was assessed by the broth microdilution test; flow cytometric procedures to measure fungal viability, mitochondrial transmembrane potential, free radical generation and cell death; as well detection of DNA damage using the comet assay. The interaction between etomidate and antifungal drugs (itraconazole and fluconazole) was evaluated by the checkerboard assay. <b>Results:</b> Etomidate showed antifungal activity against resistant strains of <i>Candida</i> spp. in planktonic cells and biofilms. Etomidate also presented synergism with fluconazole and itraconazole in planktonic cells and biofilms. <b>Conclusion:</b> Etomidate showed antifungal activity against <i>Candida</i> spp., indicating that it is a possible therapeutic alternative.