Evaluation of the antifungal activity in vitro of midazolam against fluconazole-resistant Candida spp. isolates

Aim: The purpose of this study was to evaluate the antifungal activity of midazolam, alone and in association with azoles, against isolates of clinical Candida spp. in planktonic and biofilm form. Materials & methods: The antifungal activity was observed using the broth microdilution technique. Flow cytometry tests were performed to investigate the probable mechanism of action and the comet test and cytotoxicity test were applied to evaluate DNA damage. Results: Midazolam (MIDAZ) showed antifungal activity against planktonic cells (125-250 mu g/ml) and reduced the viability of Candida spp. biofilms (125 a 2500 mu g/ml). The interaction of MIDAZ against Candida spp. biofilms was observed through scanning electron microscopy, causing alteration of their appearance. Therefore, MIDAZ has antifungal potential against Candida spp.

Automated summary

This study revealed that midazolam has antifungal activity against planktonic Candida cells and can reduce the viability of Candida biofilms. Scanning electron microscopy showed that midazolam can alter the appearance of Candida biofilms.