Antifungal effect of atorvastatin in comparison with fluconazole on Candida species isolated from patients undergoing head-and-neck radiotherapy
Open accessAbstract
Background: Head-and-neck radiotherapy can change oral Candida species and lead to the development of refractory oral candidiasis resistant to the commonly prescribed antifungal medications such as fluconazole. Atorvastatin exerts an antifungal effect by inhibiting the synthesis of fungal wall ergosterol and impairing mitochondrial function. This study aimed to compare the antifungal effects of fluconazole and atorvastatin on Candida species isolated from patients undergoing head-and-neck radiotherapy. Materials and Methods: In this clinical in vitro study, swab samples were collected from 33 patients admitted to Isfahan Seyed-O-Shohada Hospital before the onset and 2 weeks after the initiation of radiotherapy. The antifungal effects of fluconazole and atorvastatin were evaluated by the microdilution test according to the Clinical and Laboratory Standards Institute standards, and measuring their minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC). Data were analyzed by the Mann–Whitney U -test and the statistical significance level was considered P < 0.05. Results: The results showed that the MIC24, MIC48, and MFC of fluconazole were significantly lower than those of atorvastatin for Candida albicans , Candida tropicalis , and Candida glabrata both before ( P < 0.001 for all) and during ( P < 0.001 to P = 0.003) radiotherapy. Conclusion: According to the results, fluconazole has antifungal effects comparable to those of atorvastatin, but in much lower doses. Atorvastatin showed optimal antifungal effects but in doses beyond the clinically applicable threshold.
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Fluconazole has significantly greater potency than ATV against C. albicans, C. tropicalis, and C. glabrata isolated from patients undergoing head and neck radiotherapy, both before and after radiotherapy.
“While ATV exhibited measurable antifungal effects, fluconazole demonstrated significantly greater potency at substantially lower concentrations against C. albicans , C. tropicalis , and C. glabrata , both before and after radiotherapy.”
From Statins as Antifungal Agents: A Review on Drug Repurposing and Nanotechnology-Driven Delivery Strategies (2025) · cites this paper as [124]
The Abstract Results report significantly lower MIC24, MIC48, and MFC values for fluconazole than for atorvastatin against all three named species before and during radiotherapy. The Materials and Methods specify that the later samples were taken two weeks after radiotherapy began, not after the course was completed; the claim’s ‘after radiotherapy’ timing is therefore unsupported. (LLM, conf=0.88)
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Cites
Emerging opportunistic yeast infections
Miceli, M. H., Díaz, J. A., & Lee, S. A. (2011) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(10)70218-8 · Cited by 811 · see citing works
The changing epidemiology of invasive candidiasis
Hachem, R. Y., Hanna, H. A., Kontoyiannis, D. P., Jiang, Y., & RAAD, I. I. (2008) · Cancer · doi:10.1002/cncr.23466 · Cited by 330 · see citing works
Sipsas, N. V., Lewis, R. E., Tarrand, J., Hachem, R., Rolston, K. V., Raad, I. I., & Kontoyiannis, D. P. (2009) · Cancer · doi:10.1002/cncr.24507 · Cited by 269 · see citing works
Adaptation to environmental pH in Candida albicans and its relation to pathogenesis
Davis, D. A. (2003) · Current Genetics · doi:10.1007/s00294-003-0415-2 · Cited by 196 · see citing works
Parotid and submandibular/sublingual salivary flow during high dose radiotherapy
Burlage, F. R., Coppes, R. P., Meertens, H., Stokman, M. A., & Vissink, A. (2001) · Radiotherapy and Oncology · doi:10.1016/s0167-8140(01)00427-3 · Cited by 176 · see citing works
Drug-Resistant<i>Candida glabrata</i>Infection in Cancer Patients
Farmakiotis, D., Tarrand, J. J., & Kontoyiannis, D. P. (2014) · Emerging Infectious Diseases · doi:10.3201/eid2011.140685 · Cited by 152 · see citing works
Infection-related gene expression in Candida albicans
Brown, A. J. P., Odds, F. C., & Gow, N. A. R. (2007) · Current Opinion in Microbiology · doi:10.1016/j.mib.2007.04.001 · Cited by 148 · see citing works
Growth inhibition of<i>Candida</i>species and<i>Aspergillus fumigatus</i>by statins
Macreadie, I. G., Johnson, G., Schlosser, T., & Macreadie, P. I. (2006) · FEMS Microbiology Letters · doi:10.1111/j.1574-6968.2006.00370.x · Cited by 136 · see citing works
Identifying infection-associated genes of<i>Candida albicans</i>in the postgenomic era
Wilson, D., Thewes, S., Zakikhany, K., Fradin, C., Albrecht, A., Almeida, R., Brunke, S., Grosse, K., Martin, R., Mayer, F., et al. (2009) · FEMS Yeast Research · doi:10.1111/j.1567-1364.2009.00524.x · Cited by 115 · see citing works
Oropharyngeal candidiasis in head and neck cancer patients treated with radiation: update 2011
Bensadoun, R., Patton, L. L., Lalla, R. V., & Epstein, J. B. (2011) · Supportive Care in Cancer · doi:10.1007/s00520-011-1154-4 · Cited by 105 · see citing works
Westermeyer, C., & Macreadie, I. G. (2007) · FEMS Yeast Research · doi:10.1111/j.1567-1364.2006.00194.x · Cited by 73 · see citing works
Kontoyiannis, D. P. (2007) · Clinical Infectious Diseases · doi:10.1086/512817 · Cited by 69 · see citing works
Systematic review of the in vitro effects of statins on oral and perioral microorganisms
Ting, M., Whitaker, E. J., & Albandar, J. M. (2015) · European Journal Of Oral Sciences · doi:10.1111/eos.12239 · Cited by 57 · see citing works
Karbach, J., Walter, C., & Al‐Nawas, B. (2011) · Clinical Oral Investigations · doi:10.1007/s00784-011-0612-1 · Cited by 51 · see citing works
pH Regulates White-Opaque Switching and Sexual Mating in Candida albicans
Sun, Y., Cao, C., Jia, W., Li, T., Guan, G., & Huang, G. (2015) · Eukaryotic Cell · doi:10.1128/ec.00123-15 · Cited by 46 · see citing works
Simvastatin inhibits planktonic cells and biofilms of Candida and Cryptococcus species
Brilhante, R. S. N., Caetano, É. P., de Oliveira, J. S., Castelo‐Branco, D. D. S. C. M., Souza, E. R. Y., de Alencar, L. P., Cordeiro, R. D. A., Bandeira, T. D. J. P. G., Sidrim, J. J. C., & Rocha, M. F. G. (2015) · The Brazilian Journal of Infectious Diseases · doi:10.1016/j.bjid.2015.06.001 · Cited by 42 · see citing works
Bulacio, L., Paz, M., Ramadán, S., Ramos, L., Pairoba, C. F., Sortino, M. A., Escovich, L., & López, C. C. O. (2012) · Journal de Mycologie Médicale · doi:10.1016/j.mycmed.2012.08.002 · Cited by 40 · see citing works
Oropharyngeal candidosis relative frequency in radiotherapy patient for head and neck cancer
Suryawanshi, H., Ganvir, S. M., Hazarey, V. K., & Wanjare, V. (2012) · Journal of Oral and Maxillofacial Pathology · doi:10.4103/0973-029x.92970 · Cited by 36 · see citing works
Ramla, S., Sharma, V., & Patel, M. (2015) · Supportive Care in Cancer · doi:10.1007/s00520-015-3035-8 · Cited by 35 · see citing works
de Paula, S. B., Morey, A. T., Santos, J. P., dos Santos, P. M. C., Gameiro, D. G., Kerbauy, G., Sena, E. M., Ueda, L. T., Carneiro, M., Pinge‐Filho, P., et al. (2015) · The Journal of Infection in Developing Countries · doi:10.3855/jidc.6970 · Cited by 34 · see citing works
Statins in candidemia: clinical outcomes from a matched cohort study.
Forrest, G. N., Kopack, A. M., & Perencevich, E. N. (2010) · BMC Infectious Diseases · doi:10.1186/1471-2334-10-152 · Cited by 33 · see citing works
Zida, A., Yacouba, A., Bamba, S., Sangaré, I., Sawadogo, M., Guiguemdé, T. R., Kone, S., Traoré, L. K., Ouedraogo-Traoré, R., & Guiguemdé, R. T. (2017) · Journal de Mycologie Médicale · doi:10.1016/j.mycmed.2017.07.001 · Cited by 30 · see citing works
Oral Candida species in head and neck cancer patients treated by radiotherapy
de Freitas, E. M., Nobre, S. A. M., Pires, M. B. D. O., Faria, R. V. J., Batista, A. U. D., & Bonan, P. R. F. (2012) · Auris Nasus Larynx · doi:10.1016/j.anl.2012.11.011 · Cited by 29 · see citing works
Katiraee, F., Teifoori, F., & Soltani, M. (2015) · Current Medical Mycology · doi:10.18869/acadpub.cmm.1.3.11 · Cited by 29 · see citing works
Antifungal effect of Atorvastatin against Candida species in comparison to Fluconazole and Nystatin
Nasr Esfahani, A., Golestannejad, Z., Khozeimeh, F., Dehghan, P., Maheronnaghsh, M., & Zarei, Z. (2019) · Medicine and Pharmacy Reports · doi:10.15386/mpr-1209 · Cited by 28 · see citing works
Self-citationKurnatowski, P., Moqbil, S., & Kaczmarczyk, D. (2014) · PubMed · Cited by 22 · see citing works
Chou, Y.-C., Wang, Y., Charng, M., & Ueng, Y. (2013) · Journal of Food and Drug Analysis · doi:10.1016/j.jfda.2013.05.003 · Cited by 20 · see citing works
Raj, S., Sharma, D., Mate, P. U., Capoor, M. R., & Bhowmik, K. T. (2017) · Indian Journal of Cancer · doi:10.4103/ijc.ijc_155_17 · Cited by 13 · see citing works
Dambroso, D., Svidzinski, T. I. E., Svidzinski, A. E., Dalálio, M. M. D. O., & Moliterno, R. A. (2009) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 10 · see citing works
Ainapur, M. A. R., Mahesh, P., Kumar, K., Deepak, A., Mrinal, U., & Sharada, P. (2017) · Journal of Oral and Maxillofacial Pathology · doi:10.4103/0973-029x.203793 · Cited by 8 · see citing works
Differential Sensitivity of the Species of Candida parapsilosis Sensu Lato Complex Against Statins
Szenzenstein, J., Gácser, A., Grózer, Z., Farkas, Z. J., Nagy, K., Vágvölgyi, C., Márki‐Zay, J., & Pfeiffer, I. (2013) · Mycopathologia · doi:10.1007/s11046-013-9689-1 · Cited by 6 · see citing works
Golestannejad, Z., Khozeimeh, F., Najafizade, N., Tabesh, A., Faghihian, E., Maheronnaghsh, M., Kheirkhah, M., Hosseini, S. M., Sadeghalbanaei, L., Jamshidi, M., et al. (2023) · Dental Research Journal · doi:10.4103/1735-3327.377583 · Cited by 4 · see citing works
Self-citation
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Research works printed but not linked: 1
- [16]Katiraee F Teifoori F Soltani M Emergence of azole-resistant Candida species in AIDS patients with oropharyngeal candidiasis in Iran Curr Med Mycol 2015 1 11 6 28680991 PMC5490324
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e Silva, D. M., de Souza Lacerda, L., de Souza Andrioli, A., Braz, W. R., Campos, L. M., de Paiva, M. R. B., Pittella, F., Fabri, R. L., & Tavares, G. D. (2025) · Fundamental & Clinical Pharmacology · doi:10.1111/fcp.70046 · Cited by 7 · see citing works
- Authors
- Golestannejad, Z., Dehghan, P., Najafizade, N., Kheirkhah, M., Bafrani, M. E., Tabesh, A., Nadian, F., & Khozeimeh, F.
- Affiliations
- Isfahan University of Medical Sciences (IR)
- Dental Students’ Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Prosthodontics, School of Dentistry, Shahre Kord University of Medical Sciences, Shahre Kord, Iran
- Corresponding author
- Khozeimeh, Faezeh
- Venue
- Dental Research Journal
- Published
- 2024-12
- Volume
- 21
- Issue
- 1
- Pages
- 68-68
- ISSN
- 1735-3327 (ISSN-L)
- 2008-0255
- PMC
- PMC11722742
- OpenAlex
- W4405646038
- Cited by
- 1
- References
- 32
- Citations by year
- 2025: 1
- FWCI
- 0.35
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Dental Research Journal (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Oral health in cancer treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › HIV/AIDS oral health manifestations
- Keywords
- atorvastatin, fluconazole, antifungal activity, Candida, oral candidiasis, head and neck radiotherapy, Candida albicans, Candida tropicalis, Candida glabrata, minimum inhibitory concentration, minimum fungicidal concentration, drug repurposing
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