Abstract

Background: The emerging of non-albicans Candida species and Candida species have becoming potential clinical pertinence among numerous patients with vulvovaginal candidiasis. Routine treatment option include fluconazole as a primary therapeutic choice for the management of both recurrent and vulvovaginal candidiasis. However, concomitant increase in both acquired and inherent resistance of fluconazole against the diseases have been reported. Medical-Grade Honey has immunomodulatory, protective and antimicrobial activity that constitutes a reputed alternative treatment against Candida species mediated vaginal infections.

Aim: This study examined the efficacy of Medical-Grade Honey against vulvovaginal candidiasis compared to fluconazole therapy.

Method: This study examines the in vitro studies of the potency of Medical-Grade Honey against vulvovaginal candidiasis.

Results: The study showed that Medical-Grade Honey is more effective against vulvovaginal candidiasis compared to fluconazole that have positive effect on Candida species and antimicrobial activity. The synopsis of in vitro studies evaluating the antimicrobial activity of Medical-Grade Honey against Candida species showed that Candida albicans had the highest percentage frequency of 34.48% (10.00). The rate of antimicrobial activity of the substrate on different clinical isolates revealed that the substrate 8 (Local produced honey) have potential antimicrobial activity on Candida albicans, Candida tropicalis, Candida glabrata, Candida krusei, Candida kefyr and Candida dubliniensis with the percentage frequency of 20.69% (6.00). The lower limit of Minimum Inhibitory Concentration (MIC) value of different substrates revealed that the substrates 6 (Monofloral lavender honey) had the lowest MIC value with percentage frequency of 4.65% (16.00). The upper limit of MIC value of different substrates revealed that the substrate 5 (Honey and Miconazole) had the highest MIC value with percentage frequency of 14.78% (80.00).

Conclusion: From the reported in vitro studies, Medical-Grade Honey especially Monofloral Lavender Honey can be used against vulvovaginal candidiasis due to present of high fluconazole resistance rate issues. Monofloral Lavender Honey inhibit the growth of all Candida species and has the lowest minimum inhibitory concentration (MIC) which indicated that the honey is more effective as antifungal agents against the disease. Medical-Grade Honey has proven the effectiveness of immunomodulatory, protective, antimicrobial activity and can serve as alternative therapy against vulvovaginal candidiasis. This study suggest further in vivo analysis to confirm the effectiveness of Medical-Grade Honey against the disease.

Keywords: Candida Species; Fluconazole; Vulvovaginal Candidiasis; In Vitro Studies; Medical-Grade Honey; In Vivo Analysis

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