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Antifungal activity of eight commercially antifungal drugs and cinnamon oil were 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 CloCin 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.

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