Antifungal and antibiofilm activities of selective serotonin reuptake inhibitors alone and in combination with fluconazole
Articles > Article · 2020
Authors: YAMAÇ TEKİNTAŞ, AYBALA TEMEL, Ayşegül ATEŞ DEĞİRMENCİ, Bayrı ERAÇ, Dilek Yeşim METİN, Süleyha HİLMİOĞLU POLAT, Mine HOŞGÖR LİMONCU
Turkish Journal of Pharmaceutical Sciences, Journal Indexed in SCI Expanded, International, Scopus, 2020, vol 16, pp 667-672
DOI: 10.4274/tjps.65481
Summary
INTRODUCTION: Candida spp.are clinically important pathogens that cause the difficulties for treatment by biofilm formation.Considering antifungal resistance rates and the limitations in discovery of new antifungals, it's getting more important the antifungal and antibiofilm effects of various drugs which are using for different therapeautic purposes.The main goal of our study was to determine antifungal and antibiofilm effects of selective serotonin reuptake inhibitors (SSRIs) sertraline (SRT), paroxetine (PRX), fluoxetine (FLX), alone and in combination with fluconazole (FLC), against Candida spp.METHODS: Twenty Candida spp.strains isolated from clinical samples at Ege University Hospital, were identified by Dalmau method and matriks assisted laser desorption ionization time of flight mass spectrometry.Minimum inhibitory concentrations of SSRIs and fluconazole were detected by broth microdilution method.Synergistic interactions between SSRIs and fluconazole were investigated by checkerboard assay.The antibiofilm effects of SSRIs were determined by spectrophotometric microplate method.RESULTS: Five different Candida spp.(Candida albicans, Candida glabrata, Candida krusei, Candida tropicalis, Candida parapsilosis) were identified among the isolates.The MIC ranges of SSRIs were found as 16-512 µg/mL.It was detected that sertraline was the agent have highest antifungal effect.The antibiofilm efficacy of fluoxetine was found to be higher than other SSRIs.Additionally, fluoxetine and paroxetine showed synergistic effect with fluconazole in thirteen and ten isolates, respectively.Nine isolates were detected as moderate biofilm producer, four isolates were identified as strong biofilm producer.C. parapsilosis strains showed higher biofilm production than other species.Fluoxetine and sertraline alone, at MIC/2, inhibited mature biofilms in six and five isolates, respectively while paroxetine was found to increase biofilm formation in seven isolates.DISCUSSION AND CONCLUSION: This study revealed that sub-MICs of SSRIs could have antifungal and antibiofilm effects.The antidepressants sertraline and fluoxetine, alone and in combination with antifungals are considered to may have therapeutic potential for combating fungal infections.