Antibiofilm Activity of Curcumin and Piperine and Their Synergistic Effects with Antifungals against Candida albicans Clinical Isolates
Table 3
Minimum inhibitory concentration (MIC) and effects of the combination of curcumin/piperine with amphotericin B, nystatin, clotrimazole, and fluconazole on C. albicans isolates.
Isolates
ATF
MIC (μg/mL)
MIC reduction fold (antifungals)
FICI/INT
Alone
Combined
ATF
Cur
Pip
ATF/Cur
Cur
ATF/Pip
Pip
ATF/Cur
ATF/Pip
ATF/Cur
ATF/Pip
ATCC 9002
AmB
32
128
512
32
256
128
128
1
0.25
3/Ind
4/Ant
Nys
64
128
512
16
32
2
64
4
32
0.5/Syn
0.15/Syn
Clo
128
128
512
32
64
8
128
4
16
0.75/Add
0.31/Syn
Flu
128
128
512
64
64
0.25
128
2
512
1/Add
0.5/Syn
Ca02
AmB
0.25
32
512
8
128
0.03
64
0.03
8
4.13/Ind
0.25/Syn
Nys
32
32
512
4
16
16
128
8
2
0.62/Add
0.75/Add
Clo
16
32
512
8
16
4
64
2
4
1/Add
0.37/Syn
Flu
128
32
512
16
8
0.06
128
8
256
0.31Syn
0.31/Syn
Ca03
AmB
2
32
32
1
128
0.5
16
2
4
4.5/Ant
0.75/Syn
Nys
16
32
32
8
32
128
64
2
0.12
1.5/Add
10/Ant
Clo
32
32
32
8
64
1
8
4
32
2.25/Ind
0.28/Syn
Flu
128
32
32
4
8
1
128
32
128
0.28/Syn
5/Ant
Ca10
AmB
64
128
128
16
64
128
64
4
0.5
0.75/Add
2.5/Ind
Nys
64
128
128
16
64
128
64
4
0.5
0.75/Add
2.5/Ind
Clo
4
128
128
1
64
2
64
4
2
0.75/Add
1/Add
Flu
64
128
128
256
128
0.03
16
0.25
2048
5/Ant
0.15/Syn
C 13
AmB
64
16
128
64
32
32
512
1
2
3/Ind
4.5/Ant
Nys
128
16
128
2
4
128
64
64
1
0.26/Syn
1.5/Ind
Clo
2
16
128
8
64
0.5
128
0.25
4
8/Ant
1.25/Ind
Flu
128
16
128
32
32
0.25
256
4
512
2.25/Int
2.25/Ind
Ca14
AmB
1
256
512
0.25
64
0.25
64
4
4
0.5/Syn
0.38/Syn
Nys
32
256
512
8
64
4
128
4
8
0.5/Syn
0.37/Syn
Clo
32
256
512
4
128
4
128
8
8
0.62/Add
0.37/Syn
Flu
32
256
512
64
128
0.06
128
0.5
2048
2.5/Ind
0.31/Syn
Ca16
AmB
32
16
256
64
64
1
128
0.5
32
6/Ant
0.58/Add
Nys
64
16
256
32
32
1
64
2
64
2.5/Ind
0.26/Syn
Clo
16
16
256
8
32
8
64
2
2
2.5/Ind
0.75/Ind
Flu
8
16
256
4
8
0.125
64
2
64
1/Add
0.37/Syn
MIC: minimum inhibitory concentration; Cur: curcumin; Pip: piperine; ATF: antifungals; ATF/Cur: a combination of antifungal with curcumin; ATF/Pip: a combination of antifungals with piperine; FICI: fractional inhibitory concentration index; INT: interpretation; Syn: synergy, Add: additivity; Ind: indifference; Ant: antagonism; C.a: C. albicans isolate; ATCC 9002: American Type Culture Collection strain. AMB: amphotericin B; NYS: nystatin, CLO: clotrimazole; FLU: fluconazole.
