Synergistic fungicidal activity of the lipopeptide bacillomycin D with amphotericin B against pathogenic Candida species

In the present study, the synergism of the lipopeptide bacillomycin D in combination with the polyene amphotericin B against pathogenic Candida species is described along with their potential cytotoxicity against mammalian cells. Bacillomycin D inhibited the growth of various Candida species at minimal concentrations from 12.5 to 25 μg ml−1. Furthermore, it showed a synergistic effect with the antifungal drug amphotericin B in inhibiting the growth of Candida strains, with fractional inhibitory concentration indices ranging from 0.28 to 0.5. Time killing studies revealed a >2-log reduction in the viability of Candida albicans ATCC 10231 cells after 3 h incubation with the combination amphotericin B plus bacillomycin D, at their subinhibitory concentration. Interestingly, when the two drugs were used together at those dosages displaying a synergism in the anti-Candida activity, no cytotoxic effect was observed against mammalian cells. Therefore, the combination bacillomycin D/amphotericin B may represent a valid alternative to conventional antifungals for topical treatment of C. albicans infections. To the best of our knowledge, this is the first report describing the in vitro interaction between the antifungal drug amphotericin B and bacillomycin D against pathogenic Candida species. The combination of the lipopeptide bacillomycin D with the polyene antifungal drug amphotericin B allows a fungicidal activity of Candida species and offers the possibility to decrease the toxicity of bacillomycin D.