Abstract: One hundred patients [60 women with vulvovaginal candidiasis (VVC) and 40 with skin candidiasis] were
included in the present study. The VVC and skin candidiasis were detected by both clinical and microbiological
examination. The susceptibility of a total 100 Candida albicans isolates to 7 common antifungal agents was
determined. The incidence of resistance to the tested drugs ranged from 12% to 61% . Lowest percentage of resistance
was to tioconazole while the highest one was to fluconazole. The effects of combining ascorbic acid, Pimecrolimus
(SDZ ASM 981, Elidel®) with different antifungal agents against C. albicans were investigated. The results of
combination with ascorbic acid revealed that the percent reduction of resistacne was in the range of 12.7% to 78.1%.
The highest value was observed with miconazole (78.1 %) while nystatin showed the lowest value (12.7%). Time killing
curve of C. albicans American Type Culture Collection (ATCC32354) was conducted in presence and absence of
ascorbic acid with miconazole. The results revealed about 5 log reduction in the number of viable cells. the vaginal and
skin miconazole ascorbic acid cream was found to be highly effective in eradicating the candidiasis and curing the
clinical symptoms of the disease when used once daily for seven days. On the other hand, the in vitro activity of
combination of pimccrolimus (Elidel) cream with miconazole and ascorbic acid showed higher activity against C.
albicans than miconazole ascorbic acid cream. These results revealed the synergistic activity of ascorbic acid or
pirnecrolirnus to antifungal agents against C. albicans resistant tisolatcs,