Comparative evaluation of antifungal activity of melaleuca oil and fluconazole when incorporated in tissue conditioner: an in vitro study.

PURPOSE This in vitro study sought to compare the antifungal activity of melaleuca alternifolia oil and fluconazole mixed with a tissue conditioner. MATERIALS AND METHODS By testing several concentrations of fluconazole and melaleuca oil in Visco-gel, the minimum most effective concentration of each antifungal agent against Candida albicans was determined. Mean inhibition diameter (MID) was used to measure the antifungal activity, and data were analyzed statistically for significance of findings. To determine the minimum most effective concentration of fluconazole, different concentrations of 1%, 3%, 5%, and 10% w/w in Visco-gel were tested on Sabouraud dextrose agar pregrown with C. albicans. MIDs were measured at 24 hours and on day 7, while carrying out the monitoring every day. Similarly, the minimum most effective concentration of melaleuca oil in Visco-gel was found by testing it in several concentrations (1%, 5%, 10%, 20%, 25%, 27.5%, 30%, 35% w/w). Subsequently, the minimum most effective concentration of each antifungal agent was used to compare the antifungal activity against C. albicans over 7 days using the same procedure and using plain tissue conditioner as the control. RESULT The minimum most effective concentrations of melaleuca oil in Visco-gel and fluconazole in Visco-gel were 30% w/w and 5% w/w, respectively. Thirty percent w/w melaleuca oil was found to be the most effective (p < 0.001) and superior to 5% fluconazole in Visco-gel, as it retained substantial antifungal activity (MID), even on day 7 when fluconazole had lost its antifungal effect completely as evidenced by regrowth of C. albicans by day 7. CONCLUSION Thirty percent melaleuca oil in tissue-conditioner Visco-gel was superior to 5% fluconazole in Visco-gel as an antifungal agent. Though both showed comparable antifungal activity at 24 hours against C. albicans, fluconazole had completely lost it by day 7, whereas melaleuca oil had substantially retained its antifungal action.