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    Synergistic effect of thymoquinone and nystatin in the treatment of oral candidiasis; an in vitro study
    (SPRINGER, ONE NEW YORK PLAZA, SUITE 4600 , NEW YORK, NY 10004, UNITED STATES, 2021) Özdal Zincir, Özge; Özdal, Umut; Ünlü, Özge; Demirci, Mehmet; Katiboğlu, Ahmet Bülent; Egil, Edibe; Altan Şallı, Gülay
    The efectiveness of antifungal agents may be insufcient against resistant strains in some cases of oral candidiasis. The aim of this study was to evaluate the antifungal efect of thymoquinone against Candida albicans, Candida tropicalis, Candida glabrata and Candida krusei strains and the synergistic antifungal activity of these strains in combination with nystatin. To evaluate in vitro antifungal activity and interactions between thymoquinone and nystatin, substances were tested against Candida albicans ATCC 10,231, C. tropicalis ATCC 750, C.krusei ATCC 6258 and C. glabrata ATCC 2001 standard strains both individually and combinationally via microdilution method. MIC and ?FIC index value were analysed. The Kruskal Wallis test and Bonferroni test were used for statistical evaluations. Statistical signifcance was set at p<0.05. A statistically signifcant diference was observed between the mean ranks of all Candida species and doses of thymoquinone, nystatin, and the combination thymoquinone-nystatin (p<0.05). MIC values for thymoquinone were determined as 15 ?g/mL for C. albicans, C. tropicalis and C. krusei while it was 30 ?g/mL for C. glabrata. Moreover, MIC for nystatin was found as 1.875 ?g/mL for C. albicans, C. tropicalis and C. krusei, whereas it was 7.5 ?g/mL in C. glabrata. Interaction assays and ?FIC index value revealed that, TQ and nystatin have a synergistic efect against to all strains. Thymoquinone was found to have antifungal activity on Candida species and synergistic efect when combined with nystatin.