In vitro assessment of antifungal potential of apple cider vinegar and acetic acid versus fluconazole in clinical isolates of otomycosis

Abstract EN

Background : There has been an increase in the prevalence of otomycosis in recent years.

This has been linked to the extensive use of antibiotics, use of immunosuppressant drugs and steroids for a variety of malignant and immunological diseases.

Treatment of otomycosis is challenging, and requires a close follow-up ; in addition treatment with topical or systemic antifungal drugs might be associated with problems of resistance, mucosal irritation, and systemic toxicities.

Candida albicans and Aspergillus niger are the most commonly identified organisms.

Aim : the aim of this study is to investigate the antifungal potential of apple cider vinegar and acetic acid in a hope to find a safer alternative to traditional antifungal drugs in treatment of otomycosis.

Patients and methods : ear swaps were collected from 18 patients attending otolaryngology outpatient clinic-Al-Habboobi Hospital who presented with aural symptoms suggestive of otomycosis.

Fungal identification was done depending on microscopical and colonial morphology.

Antifungal effect of the tested agents was assessed by agar well-diffusion assay.

Results : 18 samples were examined, 13 (72 %) of them were positive for fungal growth, 6 were Aspergillus niger, 1 was Aspergillus flavus, 2 were Candida albicans, and the other 4 were Non-Candida albicans.

Apple cider vinegar (5 %) inhibits growth of Aspergillus niger, Aspergillus flavus, Candida albicans and Non-Candida albicans with average diameter of inhibition zones of 15mm, 13mm, 17.5mm, 17 mm respectively, while the average diameters noted with acetic acid 2 % were 10.5mm, 11mm, 13mm, 13.5mm respectively.

Fluconazole (5mg / ml) inhibits growth of the Aspergillus niger, Aspergillus flavus with average diameters of 14mm, 20mm respectively, while cause no inhibition of Candida albicans and Non-Candida albicans.

Conclusion : Apple cider vinegar and acetic acid have significant antifungal activity at the tested concentrations against Aspergillus niger, Aspergillus flavus, and fluconazole resistant Candida albicans and Non-Candida albicans.