Due to the increasing resistance of various Candida species to azole drugs, particularly fluconazole, it would be of significant importance to look for alternative therapies. The aim of this study was to investigate the antifungal activity of capric acid and its in vitro interactions with nystatin and fluconazole against Candida isolates. A total of 40 Candida isolates (C. albicans, 36; C. kefyr, 2; C. tropicalis, 1; C. glabrata, 1) collected from the oral cavity of neonates with oropharyngeal candidiasis and a reference strain of C. albicans (ATCC 10231) were used in this study. Antifungal activity of capric acid and two comparator antifungal drugs, namely fluconazole and nystatin, was tested according to CLSI M27-A3/M60 method. The in vitro interaction between capric acid with fluconazole and nystatin was determined following a checkerboard method and results were interpreted using fractional inhibitory concentration index. Nystatin had the lowest minimum inhibitory concentrations (range, 0.125–8 μg/mL; geometric mean [GM], 0.6229 μg/mL) followed by fluconazole (range, 0.5–16 μg/mL; GM, 1.9011 μg/mL) and capric acid (range, 128–2,048 μg/mL; GM, 835.9756 μg/mL). When tested in combination, capric acid with fluconazole demonstrated synergistic, indifferent, and antagonistic interactions in 3 (7.317%), 24 (58.536%), and 14 (34.146%) cases, respectively. For combination of capric acid with nystatin, synergistic, indifferent, and antagonistic interactions were observed in 1 (2.439%), 19 (46.341%), and 21 (51.219%) cases, respectively. All cases of synergistic interactions were against resistant or susceptible dose-dependent isolates. Fluconazole, nystatin, and capric acid seem to be more effective when they are used alone compared with their combination. However, their combination might be effective on resistant isolates.

中文翻译：

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癸酸，制霉菌素和氟康唑的抗真菌活性及其对新生鹅口疮念珠菌分离物的体外相互作用。

由于各种念珠菌对唑类药物，特别是氟康唑的耐药性增加，寻找替代疗法将具有重要意义。本研究的目的是研究癸酸的抗真菌活性及其与制霉菌素和氟康唑在体外对念珠菌分离株的相互作用。从口咽念珠菌病和白色念珠菌参考菌株的新生儿口腔中共收集到40种念珠菌分离株（白色念珠菌36个；开菲氏念珠菌2个；热带念珠菌1个；光滑念珠菌1个）。（ATCC 10231）用于这项研究。根据CLSI M27-A3 / M60方法测试了癸酸和两种比较抗真菌药物氟康唑和制霉菌素的抗真菌活性。在体外按照棋盘法测定癸酸与氟康唑和制霉菌素之间的相互作用，并用分数抑制浓度指数解释结果。制霉菌素的最低抑菌浓度最低（范围为0.125–8μg/ mL；几何平均值[GM]为0.6229μg/ mL），其次是氟康唑（范围为0.5–16μg/ mL； GM为1.9011μg/ mL）和癸酸酸（范围128–2,048μg/ mL； GM，835.756μg/ mL）。组合测试时，癸酸与氟康唑分别在3（7.317％），24（58.536％）和14（34.146％）的病例中表现出协同，淡化和拮抗作用。对于癸酸和制霉菌素的组合，分别在1（2.439％），19（46.341％）和21（51.219％）的病例中观察到协同，冷漠和拮抗作用。协同相互作用的所有情况都针对耐药性或易感剂量依赖性分离株。与单独使用氟康唑，制霉菌素和癸酸相比，氟康唑，制霉菌素和癸酸的组合效果更好。但是，它们的组合可能对耐药菌株有效。