Halal Alternative Formulation to Enhance Sertraline/ Fluconazole Antifungal Activity and Minimize Drug Side Effect in Cryptococcus Meningitis

Development of drug resistance in Cryptococcus meningitis CM or (C. neoformans), which causes around 1 million symptomatic infections yearly, have an overwhelming impact on human health. Up to 60% of meningitis patients experienced relapse due to drug resistance that were linked mostly to Fluconazole.  The limited array of antifungal drugs and the global resistance in C. neoformans vindicates the need to develop new therapeutic approaches. The objective of this research is to utilize a halal nanoemulsion formulation that maximizes the drug bioavailability, minimizes drug toxicity and resistance to C. neoformans. Four nanoemulsions (NEs) of clove oil, sertraline, fluconazole and sertraline/fluconazole were prepared. Particle size and polydispersity index determination (PDI) of NEs were measured utilizing Dynamic light scattering technique and Zetatrac Particle size analyzer. In vitro antifungal evaluation was applied to assess the sensitivity of the NEs using agar diffusion technique. The tested NEs showed nanometric size with PDI ranging from 0.281 to 0.493 indicating homogenously dispersed systems and elicited stronger zone of inhibition compared to same drugs suspended in water. As NEs formulation showed greater antifungal inhibition zone compared to traditional formulation, these findings can be utilized to produce a Halal potent antifungal drug using minimal inhibitory concentration that generate maximum effect.