In Vitroandin Vivoevaluation Of The Antifungal Activity Of Fluoxetine Combined With Antifungals Againstcandida Albicansbiofilms And Oral Candidiasis

Candida albicansbiofilms are responsible for oral candidiasis. Fluoxetine is a widely used antidepressant, with certain anti-Candidaactivities. The antifungal activity of fluoxetine combined with various antifungals againstC. albicansbiofilms and oral candidiasis was evaluated in this study. The morphological change in the inhibition of fluoxetine onC. albicansbiofilms was observed using SEM. The interactions between fluoxetine and antifungals againstC. albicansbiofilms were evaluated using microdilution checkerboard methods, FICI and the Delta E model. The synergistic combination was testedin vivoon the mice model of oral candidiasis. SEM imaging showed fluoxetine inhibited hyphal growth and biofilm formation. Fluoxetine combined with caspofungin exhibited synergistic effects againstC. albicansbiofilms. Antagonistic effects occurred when fluoxetine was combined with amphotericin B or terbinafine. Further, the fluoxetine combined with caspofungin significantly reduced the lesion score and CFU ofC. albicanson the murine tongue (p < 0.05), and relieved oral candidiasis of the infected mice.