Antifungal Activity and Synergism with Azoles of Polish Propolis

The aim of our work was to check if one of the products of natural origin, namely honey bee propolis, may be an alternative or supplement to currently used antifungal agents. The activity of 50 ethanolic extracts of propolis (EEPs), harvested in Polish apiaries, was tested on a group of 69 clinical isolates of C. albicans. Most of the EEPs showed satisfactory activity, with minimum fungicidal concentrations (MFC) mainly in the range of 0.08-1.25% (v/v). Eradication of biofilm from polystyrene microtitration plates in 50% (MBEC50, Minimum Biofilm Eradication Concentration) required concentrations in the range of 0.04% (v/v) to more than 1.25% (v/v). High activity was also observed in eradication of biofilm formed by C. glabrata and C. krusei on the surfaces of PVC (Polyvinyl Chloride) and silicone catheters. EEPs at subinhibitory concentrations inhibited yeast-to-mycelia morphological transformation of C. albicans in liquid medium and mycelial growth on solid medium. A synergistic effect was observed for the action of EEP in combination with fluconazole (FLU) and voriconazole (VOR) against C. albicans. In the presence of EEP at concentrations as low as 0.02%, the MICs of FLU and VOR were 256 to 32 times lower in comparison to those of the drug alone. Evidence for the fungal cell membrane as the most probable target of EEPs are presented.