Synergy of fluconazole with macrophages for antifungal activity againstCandida albicans

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Abstract
The possible synergy between macrophages and fluconazole for antifungal activity against different isolates ofC. albicans was studied. The susceptibility ofC. albicans isolates to fluconazole (FCZ), when incubated in RPMI-1640 with 10% fetal bovine serum (FBS) and 10% fresh mouse serum (test medium, TM) was determined by using a quantative culture methodology. Multiplication of isolate Sh27 was strongly inhibited by FCZ, even at 1.0 µg/ml. However, FCZ even at 100 µg/ml was not fungicidal. Resident murine peritoneal macrophages (MP) incubated for 48 h in RPMI-1640+10% FBS (tissue culture medium, TCM), then challenged with Sh27 in TM for 24 h, were fungistatic (20±9%,n=4). Cultured macrophages synergized with FCZ (10 µg/ml) for fungicidal activity when co-cultured with Sh27 in TM for 24 h (46±8%) and for 48 h (74±5%),n=3. Macrophages and FCZ (10 µg/ml) could not synergize for significant killing of a less FCZ-sensitiveC. albicans isolate 94-164. Multiplication of a FCZ-resistant isolate (94–20) was not inhibited by FCZ at 10 µg/ml TM; however, macrophages and FCZ (10 µg/ml) could synergize for fungistatic (64%), but not fungicidal, activity.