In Vitro Antifungal Activity of a Medicinal Plant Extract Mixture Against Candida Species Isolated from Patients with Oral Stomatitis

Background: Ankaferd Blood Stopper® (ABS) is a hemostatic product comprising a standardized mixture of Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum, and Urtica dioica. It is used to control bleeding after extracorporeal injuries, traumatic cuts, dental operations, and surgical intervention. ABS was reported to exhibit antibacterial and germicidal activities. Objectives: This in vitro study aimed to determine the antifungal activity of ABS. Methods: In total, 114 Candida strains; 65 Candida albicans and 49 non-albicans isolated from the oral cavity of patients with oral stomatitis, as well as three reference strains of C. albicans ATCC 90028, C.parapsilosis ATCC 22019, and C.krusei ATCC 6258, were tested by agar well diffusion, disk diffusion, and time-kill curve methods in this study. The results obtained for ABS were compared with those obtained for amphotericin B (AMB). Results: ABS and AMB exhibited inhibitory zones with mean diameters of 18.2 1.4 (12-20) mm, 20.6 1.2 (18 - 23) mm by disk diffusion and 18.31.3 (15 - 20) mm, 19.92.6 (18 - 22) mm, respectively, by agar well diffusion methods for C. albicans. On the other hand, ABS and AMB showed inhibition zones with mean diameters of 19.41.5 (18 - 24) mm, 19.12.8 (13 - 30)mmby disk diffusion and 19.8 2.1 (18 - 25) mm, 18.7 2.3 (13 - 23) mm by agar well diffusion methods for non-albicans Candida isolates. ABS exhibited higher activity against non-albicans Candida species compared to C. albicans (P < 0.001). By the time kill-curve method, ABS achieved a 4 log10 cfu/mL decrease in C. albicans ATCC 90028, C. parapsilosis ATCC 22019, and C. krusei ATCC 6258, as well as seven different Candida spp. isolates of C. albicans, C. glabrata, C. tropicalis, C. guilliermondii, C. kefyr, C. krusei, and C. parapsilosis, respectively. Conclusions: ABS can be an alternative for treating superficial infections.