Antimycotic activity and phagocytosis effects of econazole in combination with ibuprofen isobuthanolammonium against vaginal strains

Vaginal infections caused by Candida spp., other yeasts and Trichomonas vaginalis are problematic mainly due to the various factors involved in development of infection and to the failure of common treatments. In this study we investigated the presence of synergistic activity of econazole and ibuprofen isobuthanolammonium against 310 different vaginal isolates, by using the microdilution broth assay to test in vitro antimicrobial activity and the effect of the two drugs on phagocytosis and intramacrophagic cellular killing of mouse peritoneal macrophages. The effect of sub-inhibitory concentrations of econazole / ibuprofen isobuthanolammonium combination on Candida albicans germ tube formation was also evaluated. The in vitro antifungal activity of econazole was notably improved by addition of ibuprofen isobuthanolammonium. Macrophage killing of C. albicans was significantly increased by the two drugs and also germ-tube formation was significantly affected. We conclude that the addition of ibuprofen isobuthanolammonium to econazole provides better in vitro antifungal activity. However, further studies are needed to elucidate the in vivo action of this formulation.