Synergism between clotrimazole and cinnamon oil: An effective (weapon) drug in vitro and in vivo against some multi drug resistant dermatophytes

Antifungal activity of eight commercially
antifungal drugs and cinnamon oilwere screened against twenty two
dermatophytic isolates of clinical origin. The strains that revealed resistance
against maximum number of antifungal drugs (under investigation) were selected
for synergistic assay using Checkerboard method. The interaction between
clotrimazole and cinnamon oil against twelve of multi-drug resistant
dermatophytic isolates in vitro revealed that this interaction was
synergistic or in-additive while antagonism was not detected; the interaction
was synergistic in the most isolates (91.67%) while inadditive was demonstrated
in only one isolate. Fifty four patients,
twenty five males and twenty nine females suffering from dermatophytic
infections were enrolled in this study to evaluate synergism between
clotrimazole and cinnamon oil in vivo. The dermatophytic infections were
confirmed by laboratory mycological method and direct microscopic examination.
The patients were randomly divided into three groups, which treated with Closol
(commercial clotrimazole topical solution), placebo and Clo-Cin topical
solution twice daily for two weeks and then followed up for two weeks. After
two weeks of the treatment in vivo 50% improvement in clotrimazole
(closol) treated patients and 81.82% in
Clo-Cin group. The rate of improvement was 25% and 100% in clotrimazole and
Clo-Cin groups respectively after four weeks of the dermatophytosis treatment.
The recurrence of dermatophytic infection in Closol treated patients
representing significant difference between the two groups. Moreover, Clo-Cin
also offered significant protection to infected tissue challenged with
irritation (clotrimazole side effect) as revealed by fluorescence microscope
result.