In vitro anti-Candida activity of Quercus infectoria gall extract-based vaginal cream and its local tissue effects in vivo

Abstract

Aims: Aqueous extract of Quercus infectoria (QI) galls has been reported to possess anti-fungal and anti-inflammatory activities. Hence, this study aimed to determine in vitro antimicrobial activity of formulated QI gall extract-based vaginal cream against Candida albicans and to evaluate the possible side effects on the cervicovaginal epithelium of healthy rats. Methodology and results: Three different cream formulations containing 10%, 20%, and 30% of QI gall extract respectively were tested for their antimicrobial activity against C. albicans (ATCC 10231) by using disc diffusion test. Microbroth serial dilution method was performed in determining the minimum inhibitory concentration (MIC) and fungicidal concentration (MFC). The 30% formulated extract cream (FEC) was applied topically on the cervicovaginal surface of healthy Sprague Dawley (SD) rats and examined for local tissue effects histologically. The mean scores of inhibition zone diameter were compared by one-way ANOVA and post-hoc test using PRISM software. All extract cream formulations displayed a relatively good anti-Candida activity. The MIC values exhibited by 10%, 20%, and 30% FEC against C. albicans were 1.094 mg/mL, 0.547 mg/mL, and 0.068 mg/mL, respectively. The 10% and 20% FECs showed a significant difference (P=0.0254) in the mean of inhibition zone diameter. The lowest MFC value (0.068 mg/mL) was shown by 30% FEC. There were no abnormal changes seen at the vagina and cervical mucosa after 2 weeks application of 30% FEC. Conclusion, significance and impact of study: QI gall extract formulated in the cream base has an anti-Candida activity in vitro and the present finding suggests that this herbal cream formulation is potentially useful in preventing vaginal candidiasis without causing any unwanted local side effects.