{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:32:21Z","timestamp":1793413941899,"version":"4.5.0"},"reference-count":61,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T00:00:00Z","timestamp":1681084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Iran University of Medical Sciences","award":["9929918907"],"award-info":[{"award-number":["9929918907"]}]},{"name":"Iran University of Medical Sciences","award":["VEGA 1\/0240\/23"],"award-info":[{"award-number":["VEGA 1\/0240\/23"]}]},{"name":"Iran University of Medical Sciences","award":["313021BUZ3"],"award-info":[{"award-number":["313021BUZ3"]}]},{"name":"Ministry of Education, Science, Research","award":["9929918907"],"award-info":[{"award-number":["9929918907"]}]},{"name":"Ministry of Education, Science, Research","award":["VEGA 1\/0240\/23"],"award-info":[{"award-number":["VEGA 1\/0240\/23"]}]},{"name":"Ministry of Education, Science, Research","award":["313021BUZ3"],"award-info":[{"award-number":["313021BUZ3"]}]},{"name":"Operation Program of Integrated Infrastructure for the project","award":["9929918907"],"award-info":[{"award-number":["9929918907"]}]},{"name":"Operation Program of Integrated Infrastructure for the project","award":["VEGA 1\/0240\/23"],"award-info":[{"award-number":["VEGA 1\/0240\/23"]}]},{"name":"Operation Program of Integrated Infrastructure for the project","award":["313021BUZ3"],"award-info":[{"award-number":["313021BUZ3"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Vulvovaginal candidiasis (VVC) is a mucous membrane infection, with an increased rate of antifungal resistance of Candida species. In this study, the in vitro efficacy of farnesol alone or in combination with traditional antifungals was assessed against resistant Candida strains recovered from women with VVC. Materials and Methods: Eighty Candida isolates were identified by multiplex polymerase chain reaction (PCR), and the antifungal susceptibility to amphotericin B (AMB), fluconazole (FLU), itraconazole (ITZ), voriconazole (VOR), clotrimazole (CTZ), and farnesol was tested by the standard microdilution method. The combinations of farnesol with each antifungal were calculated based on the fractional inhibitory concentration index (FICI). Result:\u00a0Candida glabrata was the predominant species (48.75%) isolated from vaginal discharges, followed by C. albicans (43.75%), C. parapsilosis (3.75%), a mixed infection of C. albicans and C. glabrata (2.5%) and C. albicans and C. parapsilosis (1%). C. albicans and C. glabrata isolates had lower susceptibility to FLU (31.4% and 23.0%, respectively) and CTZ (37.1% and 33.3%, respectively). Importantly, there was \u201csynergism\u201d between farnesol\u2013FLU and farnesol\u2013ITZ against C. albicans and C. parapsilosis (FICI = 0.5 and 0.35, respectively), reverting the original azole-resistant profile. Conclusion: These findings indicate that farnesol can revert the resistance profile of azole by enhancing the activity of FLU and ITZ in resistant Candida isolates, which is a clinically promising result.<\/jats:p>","DOI":"10.3390\/medicina59040743","type":"journal-article","created":{"date-parts":[[2023,4,11]],"date-time":"2023-04-11T02:02:33Z","timestamp":1681178553000},"page":"743","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Combination of Farnesol with Common Antifungal Drugs: Inhibitory Effect against Candida Species Isolated from Women with RVVC"],"prefix":"10.3390","volume":"59","author":[{"given":"Fatemeh","family":"Nikoomanesh","sequence":"first","affiliation":[{"name":"Infectious Disease Research Center, Birjand University of Medical Sciences, Birjand 9717853577, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahsa","family":"Falahatinejad","sequence":"additional","affiliation":[{"name":"Department of Medical Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14115111, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5300-3254","authenticated-orcid":false,"given":"Lucia","family":"\u010cern\u00e1kov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Virology, Faculty of Natural Sciences, Comenius University in Bratislava, 842 15 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0821-8592","authenticated-orcid":false,"given":"Andr\u00e9 Luis Souza","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Department of General Microbiology, Microbiology Institute Paulo de G\u00f3es, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-901, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahla Roudbar","family":"Mohammadi","sequence":"additional","affiliation":[{"name":"Department of Medical Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14115111, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitra","family":"Rafiee","sequence":"additional","affiliation":[{"name":"Department of Immunology, School of Medicine, Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand 9717853577, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8633-2230","authenticated-orcid":false,"given":"C\u00e9lia Fortuna","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"LEPABE\u2014Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal"},{"name":"ALiCE\u2014Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal"},{"name":"TOXRUN\u2014Toxicology Research Unit, Cooperativa de Ensino Superior Polit\u00e9cnico e Universit\u00e1rio\u2014CESPU, 4585-116 Gandra PRD, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Roudbary","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1126\/science.aaa6097","article-title":"How to Bolster the Antifungal Pipeline: Few Drugs Are Coming to Market, but Opportunities for Drug Development Exist","volume":"347","author":"Denning","year":"2015","journal-title":"Science"},{"key":"ref_2","first-page":"757","article-title":"Vulvovaginal Candidiasis: Clinical Manifestations, Risk Factors, Management Algorithm","volume":"92","author":"Eckert","year":"1998","journal-title":"Obstet. 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