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"[ABSTRAKPenelitian ini bertujuan untuk meningkatkan pemberian antijamur secara rasional berdasarkan sistem skoring infeksi Candida di Rumah Sakit Cipto Mangunkusumo (RSCM). Data faktor risiko dan evaluasi penggunaan antijamur pada pasien berisiko kandidemia di RSCM belum tersedia. Data ini diperlukan untuk mengembangkan sistem skor yang sesuai dengan kondisi di RSCM. Penelitian retrospektif ini menggunakan desain kasus kontrol dari rekam medik pasien tahun 2011-2014. Hasil penelitian menunjukkan bahwa faktor prediktor kandidemia di RSCM adalah lama perawatan, sepsis berat dan pembedahan dengan nilai ambang batas 3,5. Skor modifikasi memiliki sensitifitas lebih tinggi sedangkan spesifisitas hampir sama dengan Candida score. Penggunan skor modifikasi ini menurunkan ketidaktepatan penggunaan antijamur sebesar 7%.

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ABSTRACTThe aim of the study is to increase the rationality of antifungal usage based on Candida scoring system in Cipto Mangunkusuno hospital (RSCM). The data of risk factors and evaluation of antifungal usage in patient who have risk factors for candidemia in RSCM is not available yet. The data is important to develop a scoring system that suitable with RSCM condition. This retrospective case control study used patient medical record from 2011-2014. The result of this study showed that predictor of candidemia in RSCM are length of stay in hospital, severe sepsis and surgery, with cut off value 3.5. The modified score has higher sensitivity with equal specificity with Candida score. The modified score is able to decrease the inappropriateness of antifungal usage as high as 7%., The aim of the study is to increase the rationality of antifungal usage based on Candida scoring system in Cipto Mangunkusuno hospital (RSCM). The data of risk factors and evaluation of antifungal usage in patient who have risk factors for candidemia in RSCM is not available yet. The data is important to develop a scoring system that suitable with RSCM condition. This retrospective case control study used patient medical record from 2011-2014. The result of this study showed that predictor of candidemia in RSCM are length of stay in hospital, severe sepsis and surgery, with cut off value 3.5. The modified score has higher sensitivity with equal specificity with Candida score. The modified score is able to decrease the inappropriateness of antifungal usage as high as 7%.]"

"ABSTRAKTesis ini bertujuan menilai perbandingan efektivitas terapi adjuvan injeksi kombinasi intrastromal IS dan intrakameral IK vorikonazol VCZ dengan intrastromal IS VCZ pada ulkus kornea jamur derajat sedang akibat Aspergillus fumigatus. Uji eksperimental tersamar acak dilakukan pada 11 kelinci albino New Zealand white yang terbagi menjadi 3 kelompok, yaitu kontrol, injeksi intrastromal, serta intrastromal dan intrakameral. Parameter yang dinilai adalah perubahan klinis, mikologis, dan histopatologik kornea. Sebagian besar subjek pada grup kombinasi memperlihatkan kecendrungan perbaikan klinis dibandingkan kelompok kontrol namun tidak bermakna secara statistik p>0,05 . Pemeriksaan histopatologik memperlihatkan kecenderungan peningkatan jumlah sel radang pada kelinci yang dilakukan inokulasi pada kedua matanya.

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ABSTRACTThe purpose of this study was to compare the efficacy of intrastromal IS and combined with intracameral IK voriconazole VCZ therapy in moderate keratomycosis caused by Aspergillus fumigatus in rabbits. A randomized, masked, controlled experimental study was administered on 11 albino New Zealand white rabbits, which latter allocated into three different treatment groups of control, intrastromal VCZ and combinations. Clinical grading was performed at multiple times, while mycology analysis and histopathological examination were performed after treatment. All subjects in combination groups demonstrated a tendency of better clinical response with decreasing size of epithelial defect and infiltrate but statistically not significant p 0,05 . "

"Salah satu rempah-rempah di Indonesia yang digunakan sebagai bumbu dan juga sebagai obat tradisional adalah biji jinten putih (Cuminum cyminum) yang mengandung minyak atsiri Cumin oil) dan telah dilaporkan memiliki silat antimikroba. Penelitian ini bertujuan untuk mengetahui aktivitas antifungal minyak atsiri biji jinten putih terhadap empat spesies khamir hasil isolasi dari produk pangan dan diidentifikasi pada daerah ITS yaitu Candida parapsilosis SS25, C. orthopsilosis NN14, C. metapsilosis MP27, C. etchellsii MP18. Pengujian aktivitas anti fungal dilakukan menggunakan metode difusi medium padat dengan cakram dan metode kontak langsung, nistatin digunakan sebagai kontrol positif. Minyak atsiri yang diperoleh dari distilasi uap biji jinten putih memiliki rendemen 2,5-3,0%, tidas berwarna atau berwarna kuning muda. Hasil analisis GC-MS dari minyak atsiri jinten putih menunjukkan 12 puncak yang terdiri dari benzaldehida/kuminaldehida (35,44%), ρ -simen (34,77%), β -pinen (15,08%), γ -terpinen (8,15%). Beberapa monoterpen lainnya terdeteksi sebagai α -thujen/ α -pelandren, α-pinen, trans-limonen, cis-limonen, dan senyawa golongan alkena seperti pentilsikloheksena dan sikloheksena serta eter (apiol). Hasil pengamatan uji antifungal menunjukkan bahwa seluruh khamir uji memberikan respon sensitif terhadap minyak atsiri jinten putih dengan radius zona hambat 13,4-16,5 mm. Minyak atsiri jinten putih dapat menghambat pertumbuhan khamir uji dengan nulai MIC 0,028-0,042% dan nilai MFC 0,09%-0,14%. Minyak atsiri jinten putih memiliki aktivitas antifungal yang mangat kuat dibandingkan dengan nistatin, nilai MIC dan MFC nistatin yaitu 0,40-0,50% dan 3,0-4,0%.

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Many kinds of spices are used in Indonesia, one of them is white cumin seed. This spice is used not only for cooking, but also for traditional medicine. This study reported of antifungal activity from white cumin`s essential oil. Extraction and identification of Cumin oil were carried out. We obtained 2.5-3.0% of white essential oil which was colorless or light yellow color. GCMS analysis revealed that there were 12 peaks. Based on peak`s intensity the oil were dominated by 4 compound i.e. cuminaldehide (35.44%), ρ-cymene (34.77%), β-pynene (15.08 %) and γ-terpinene (8.15%). Growth inhibition zone determination has been carried out by diffusion disc and direct method against yeast i.e. C. parapsilosis SS25, C. orthopsilosis NN14, C. metapsilosis MP27, and C. etchellsii MP18. The results showed that all of the yeasts were sensitive to cumin oil. The inhibition zone radius were 13.4-16.5 mm. The cumin oil showed the inhibition of yeast growth with MIC values of 0.028%-0.042% and MFC values 0.09%- 0.14%, while nystatin had MIC values 0.40%-0.50% and MF C values 3.0%-4.0%. The activity of cumin oil was very strong as antifungal."

"Meningkatnya jumlah pasien lanjut usia dan pasien disfungsi imun berkontribusi terhadap tingginya beban infeksi jamur invasif di Indonesia. Keterbatasan informasi dan pedoman penggunaan antijamur sistemik di Indonesia menyebabkan penggunaannya berkaitan dengan masalah terkait obat (MTO). Di Indonesia, antijamur sistemik bentuk injeksi memiliki biaya yang tinggi dan ketersediaan yang terbatas. Penelitian cross-sectional ini bertujuan untuk mengevaluasi profil penggunaan dan MTO antijamur sistemik bentuk injeksi di RSUPN dr. Cipto Mangunkusumo Gedung A periode Januari-Desember tahun 2022. Pengambilan sampel menggunakan metode quota sampling pada data sekunder berupa rekam medis. Analisis MTO terhadap regimen pengobatan pasien difokuskan pada ketepatan dosis, ketepatan durasi, potensi interaksi obat, dan efek samping obat. Flukonazol merupakan antijamur sistemik bentuk injeksi yang paling sering digunakan (63,6%) dengan indikasi penggunaan empiris yang paling umum (41,1%). Kandidiasis merupakan jenis infeksi jamur invasif yang paling umum terjadi (26,2%) dengan median durasi pengobatan antijamur sistemik selama 9 (4-26) hari. Terdapat 45 pasien yang mengalami MTO. Termasuk dosis terlalu rendah sebanyak 4 (3,7%), durasi pengobatan terlalu singkat sebanyak 10 (9,3%), durasi pengobatan terlalu lama sebanyak 3 (2,8%), potensi interaksi obat sebanyak 19 (17,8%), dan efek samping obat sebanyak 18 (16,8%) pasien. Hasil uji Chi-square menunjukkan bahwa pasien dengan durasi pengobatan  >9 hari (p = 0,041) dan berusia >60 tahun (p = 0,005) lebih tinggi 2,438 dan 3,646 kali mengalami MTO antijamur sistemik bentuk injeksi. Temuan terkait efek samping obat dan interaksi obat memerlukan pemantauan oleh tenaga kesehatan dan implementasi protokol de-eskalasi antijamur untuk MTO terkait durasi dapat mengurangi biaya perawatan pasien di rumah sakit.

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The rising population of elderly and immunocompromised patients contributes to Indonesia's high burden of invasive fungal infections. Limited information and guidelines on systemic antifungal agents in Indonesia contribute to drug-related problems (DRPs). Moreover, in Indonesia, injectable forms of systemic antifungals have high costs and limited availability. This cross-sectional study aims to assess the utilization profile and DRP of injectable systemic antifungal medicines at dr. Cipto Mangunkusumo Hospital Building A between January and December 2022. This study utilized quota sampling of secondary data from medical records. The DRP evaluation of patient treatment regimens focused on dosage accuracy, duration accuracy, possible drug interactions, and adverse drug events (ADE). Fluconazole was the most frequently administered intravenous antifungal drug (63,66%), with empirical therapy being the primary indication for treatment (41,1%). Candidiasis was the most prevalent invasive fungal infection (26,2%), and the median duration of intravenous antifungal treatment was 9 (4-26) days. A total of 45 patients experienced DRPs, encompassing dosage too low in 4 (3,7%), treatment duration too short in 10 (9,3%), treatment duration too long in 3 (2,8%), potential drug interactions in 19 (17,8%), and ADE occurring in 18 (16,8%) patients. Chi-square analysis indicated that patients with treatment duration >9 days and those >60 years of age were 2,438 and 3,646 times more likely to experience DRPs (p = 0,041 and p = 0,005, respectively). Findings concerning ADE and potential drug interactions require monitoring by healthcare providers, and antifungal de-escalation protocols for duration-associated DRPs help reduce hospitalization costs."

"Resin adalah metabolit sekunder dari mekanisme metabolisme tanaman. Malassezia globosa adalah jamur yang umum muncul di kulit tetapi dapat menjadi infeksi oportunistik jika terbentuk dalam jumlah yang tidak wajar. Penelitian ini dilakukan untuk mengkaji aktivitas antijamur resin Belitung. Resin yang digunakan adalah resin Mampat yang didapatkan dari pohon Jangkar Asam dan resin Betor Padi yang didapatkan dari pohon Tanjung Pandan. Ekstraksi resin dilakukan dengan metode maserasi menggunakan 70% etanol selama 8 jam. Ekstrak resin kemudian dikaji dengan cara LC-MS/MS dan di uji antijamur terhadap Malassezia globosa menggunakan metode mikrodilusi. Berdasarkan penelitian yang dilakukan, terdapat 9 senyawa terindentifikasi untuk kedua resin, dengan Hederagenin dan DAPG sebagai senyawa pada resin Mampat yang mempunyai fungsi antijamur dan Tryptophyllin, DL-Malic Acid, Benzoic acid, Limonin, ?-mangostin sebagai senyawa pada resin Betor Padi yang mempunyai fungsi antijamur. Uji antijamur menunjukkan bahwa resin Mampat tidak mempunyai aktivitas antijamur yang cukup kuat dibandingkan ketokonazol sebagai kontrol positif, sedangkan absorbansi pada resin Betor Padi lebih kecil daripada ketokonazol, menunjukkan bahwa resin Betor Padi mempunyai kemampuan untuk menghambat pertumbuhan jamur Malassezia globosa.

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Resin is a secondary metabolite produced by plants from its metabolism mechanism. Malassezia globosa is a fungal that usually formed in skin but can be opportunistic pathogen in extensive amount. This research was conducted to explore the antifungal activity of resin obtained from Belitung. The resin used are Mampat resin from Jangkar Asam tree and Betor Padi resin from Tanjung Pandan tree. Resin is extracted by maceration using 70% ethanol for 8 hours. The resin extract then identified by LC-MS/MS and tested for its antifungal activity against Malassezia globosa using the broth-microdilution method. The result has found that there are 9 compounds identified for both Mampat and Betor Padi resin with Hederagenin and DAPG is the antifungal property in Mampat resin and Tryptophyllin, DL-Malic Acid, Benzoic acid, Limonin, ?-mangostin are the antifungal property in Betor Padi resin. The antifungal test shown that Mampat resin does not have an ideal antifungal activity compared to ketoconazole as the positive control, contrary to Betor Padi resin that appeared to have lower absorbance than the ketoconazole, meaning that Betor Padi resin has the potential to interfere the growth of Malassezia globosa."

"Latar belakang: Resistensi flukonazol pada Candida krusei semakin menjadi perhatian dalam pengobatan kandidiasis superfisial dan kandidemia. Propolis Lombok yang kaya akan flavonoid merupakan alternatif yang memiliki potensi. Penelitian ini mengeksplorasi aktivitas antijamur propolis Lombok terhadap pertumbuhan Candida krusei. Metode: Eksperimen in vitro ini menggunakan metode difusi agar sumuran (untuk pengukuran diameter zona hambat), dan mikrodilusi (untuk perubahan densitas optik) yang dilanjutkan dengan kultur jamur (untuk penentuan nilai KHM). Kelompok perlakuan pada metode difusi agar sumuran terdiri dari ekstrak etanol propolis Lombok pada konsentrasi 500.000 ppm, 700.000 ppm, dan 1.000.000 ppm, flukonazol (kontrol positif), dan DMSO 10% (kontrol negatif), serta penambahan kontrol pertumbuhan dan kontrol media pada metode mikrodilusi. Hasil: Terdapat perbedaan yang signifikan antar kelompok pada metode difusi agar sumuran (p = 0,025) dan mikrodilusi (p = 0,001), dengan rata-rata zona hambat terbesar pada 700.000 ppm (9,67 mm) dan rata-rata penurunan densitas optik terbesar pada 500.000 ppm (0,2308). Tes post hoc untuk metode difusi agar sumuran tidak menunjukkan perbedaan yang signifikan. Untuk metode mikrodilusi, perbedaan densitas optik secara signifikan lebih rendah untuk 500.000 ppm dibandingkan dengan kontrol negatif dan kontrol medium, serta untuk 700.000 ppm dibandingkan dengan kontrol positif, kontrol pertumbuhan, dan kontrol medium. Kultur jamur menunjukkan pertumbuhan Candida krusei pada semua konsentrasi propolis. Kesimpulan: Propolis Lombok yang didapatkan dari Trigona clypearis berpotensi menghambat pertumbuhan Candida krusei. Namun, untuk dapat dijadikan sebagai pengobatan alternatif, efeknya harus dioptimalkan. Nilai KHM tidak dapat ditentukan.

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Introduction: Candida krusei’s fluconazole resistance is a growing concern in superficial candidiasis and candidemia treatment. Lombok propolis, rich in flavonoids, is a potential alternative. This research explores the antifungal activity of Lombok propolis against Candida krusei growth. Method: In vitro experiments used Agar well diffusion (for inhibition zone diameter measurement), and Broth microdilution (for optical density changes) followed by fungal culture (for MIC determination). Groups in Agar well diffusion included Lombok propolis ethanol extracts at concentrations of 500.000 ppm, 700.000 ppm, and 1.000.000 ppm, fluconazole (positive control), and 10% DMSO (negative control), with the addition of growth control and medium control in Broth microdilution. Result: This study found significant between-group differences in Agar well diffusion (p = 0,025) and Broth microdilution (p = 0,001), with the largest average inhibition zone at 700.000 ppm (9,67 mm) and the greatest average optical density decrease at 500.000 ppm (0.2308). Post hoc tests for Agar well diffusion revealed no significant difference and for Broth microdilution the optical density difference was significantly lower for 500.000 ppm compared to negative control and medium control, as well as for 700.000 ppm compared to positive control, growth control, and medium control. Fungal culture showed Candida krusei growth at all propolis concentrations. Conclusion: Lombok propolis collected from Trigona clypearis has the potential to inhibit the growth of Candida krusei. However, to be established as an alternative treatment, its effect has to be optimized. MIC value determination was inconclusive."

"Penelitian untuk menemukan obat antijamur baru masih terus dilakukan. Asam lemak, khususnya asam risinoleat, menjadi senyawa yang menarik minat para peneliti dalam bidang ini. Pada penelitian ini dilakukan sintesis amida ester asam risinoleat teroksidasi-glisina dan amida ester asam risinoleat teroksidasi-fenilalanina melalui tiga tahapan reaksi yang meliputi reaksi esterifikasi Fischer, reaksi oksidasi pada ikatan rangkap, dan reaksi amidasi. Produk dari setiap tahap dikarakterisasi dengan KLT dan FT-IR. Hasil karakterisasi senyawa lipoamida dengan KLT menunjukkan penurunan spot yang mengindikasikan adanya senyawa lipoamida dalam produk hasil amidasi. Hasil karakterisasi produk amidasi dengan FT-IR menunjukkan senyawa amida terbentuk karena adanya gugus fungsi yang khas pada senyawa amida, yaitu gugus C=O amida, pada bilangan gelombang 1731 cm-1 untuk lipoamida-glisina dan 1733 cm-1 untuk lipoamida-fenilalanina. Hasil uji aktivitas antijamur produk amidasi menunjukkan lipoamida-glisina dan lipoamida-fenilalanina tidak mempunyai aktivitas antijamur terhadap Candida albicans.

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Research to find new antifungal drugs is still ongoing. Ricinoleic acid in particular is a fatty acid that has drawn the attention of researchers in this area. In this research, the synthesis of glycine-oxidized ricinoleic acid amide ester and phenylalanine-oxidized ricinoleic acid ester amide was carried out through three reaction steps, which included Fischer esterification reaction, oxidation reaction of the double bond, and amidation reaction. The products of each stage were characterized by TLC and FT-IR. The results of the characterization of lipoamide compounds by TLC showed a decrease in the spot’s travel length, which indicated the presence of lipoamide compounds in the amidation product. The results of the characterization of the amidation product with FT-IR showed that the amide compound was formed due to the presence of a unique functional group on the amide compound, namely the C=O amide group, at wave numbers 1731 cm-1 for lipoamide-glycine and 1733 cm-1 for lipoamide-phenylalanine. The antifungal activity test results of amidation products showed that lipoamide-glycine and lipoamide-phenylalanine do not have antifungal activity against Candida albicans."

"Pada penelitian ini, asam oleat diesterifikasi dengan dry metanol dan katalis HCl pekat dengan menggunakan refluks selama 6 jam pada suhu 60°C. Metil oleat yang terbentuk kemudian diamidasi dengan asam amino glisina dan fenilalanina yang dibantu dengan pelarut assetonitril. Selain itu, dilakukan juga amidasi langsung dari asam oleat dengan bantuan disikloheksilkarbodiimida (DCC) sebagai agen pengopling selama 2 jam pada suhu 0°C. Produk lipoamida yang terbentuk di identifikasi dengan KLT, di purifikasi dengan kromatografi kolom, dan di karakterisasi dengan FTIR. Aktivitas antifungi amida asam oleat juga ditentukan dengan metode difusi cakram terhadap Candida albicans. Hasil uji menunjukkan bahwa N-oleilglisina ACN memiliki aktivitas antifungi dengan kategori sedang, N-oleilfenilalanina ACN berkategori sedang, N- oleilglisina DCC tidak ada aktivitas, dan N- oleilfenilalanina DCC berkategori sedang.

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In this study, oleic acid was esterified with dry methanol and concentrated HCl catalyst using reflux for 6 hours at 60oC. The methyl oleate formed then amidated by glycine and phenylalanine using acetonitrile as a solvent. In addition, direct amidation of oleic acid was also carried using dicyclohexylcarbodiimide (DCC) as a coupling agent for 2 hours at 0oC temperature. The formed lipoamide product was identified by TLC, purified by column chromatography, and characterized by FTIR. The antifungal activity of oleic acid amide was also determined by disc diffusion method against Candida albicans. The result showed that N- oleylglycine ACN has moderate antifungal activity, N-oleylphenylalanine ACN has moderate category, N-oleylglycine DCC has no activity, and N-oleylphenylalanine DCC has moderate category."

"During their storage, the traditional ready-to-eat food, such as sticky rice cake, are easily contaminated by spoilage pathogens. Hence, this study aims to evaluate the effect of Citrus hystrix extract in reducing spoilage pathogens in sticky rice cake during storage. The experimental sticky rice cake was prepared and formulated with Citrus hystrix extract at varied level of concentrations of 0.65%, 1.26% and 1.82% (w/w). Treated samples were stored at room temperature for 28 days and evaluated periodically for their microbial activity (total plate count), thiobarbituric acid reactive substances (TBARS), and sensory analysis. For its antifungal activity, the Citrus hystrix extract was also compared against Penicillium sp. and Aspergillus nidulans prior to formulation. Results exhibited a significant advantage of the added extracts to the sticky rice cake. All extract levels effectively eliminated the spoilage microorganism and significantly lowered the TBARS values. The physico-chemical properties of sticky rice cake including pH, water activity, and moisture content were equal among all the formulated samples and slightly different at 1.82% (w/w) extract level. Moreover, the addition of Citrus hystrix extract up to 1.82% did not affect the acceptability sensory attributes of the sticky rice cake as compared to the control which has no Citrus hystrix extracts (p > 0.05)."

"Telah dilakukan uji aktivitas antifungi partikel nano seng oksida (NP ZnO) terhadap isolat kapang A1P dan A2C, yang di isolasi dari plafon rumah. Metode uji yang dilakukan adalah plate agar menggunakan PDA yang ditambahkan NP ZnO pada konsentrasi 0,1%; 0,25%; 0,5%; atau 1%. Pengamatan pertumbuhan kedua isolat kapang dilakukan dengan metode hanging drop menggunakan medium PDA yang mengandung NP ZnO sebesar 0,1%; 0,25%; 0,5%; 1%, 1,5%; atau 2%. Konsentrasi minimum hambatan (KMH) ditentukan dengan metode tube dilution menggunakan medium PDB dengan konsentrasi NP ZnO 0,5%; 1%; 1,5%; atau 2%. Konsentrasi minimum fungisidal (KMF) ditentukan berdasarkan jumlah sel hasil total plate count (TPC) dari perlakuan tube dilution. Hasil plate agar dan hanging drop menunjukan bahwa NP ZnO memiliki sifat fungistatik yang meningkat seiring besarnya konsentrasi. Hal tersebut diindikasikan dengan tetap adanya pertumbuhan A1P dan A2C walaupun mengalami perlambatan germinasi spora dan penurunan diameter koloni. Pada tube dilution, isolat kapang juga mengalami perlambatan pertumbuhan yang signifikan dibandingkan dengan kontrol, sesuai dengan hasil plate agar maupun hanging drop. Kedua isolat kapang tidak mengalami pertumbuhan pada cat yang ditambah NP ZnO walaupun telah di inkubasi melebihi waktu inkubasi tube dilution, selama 2 minggu.

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Antifungal activity test of zinc oxide nanoparticle (ZnO) against molds A1P and A2C, which were isolated from ceiling, has been carried out. Agar plate method test was done using PDA added with 0,1%; 0,25%; 0,5%; or 1% ZnO. Growth of the molds on PDA medium added with 0,1%; 0,25%; 0,5%; 1%, 1,5%; or 2% ZnO was observed using hanging drop method. Minimum inhibition concentration (MIC) was determined by tube dilution method in PDB medium which contains 0,5%; 1%; 1,5%; or 2% ZnO. Minimum fungicidal concentration (MFC) was determined based on cells count from total plate count (TPC) of tube dilution. Results from plate agar and hanging drop showed that ZnO worked as fungistatic which escalated along its increased concentration. This was indicated by the growth of A1P and A2C although the spore germination was slow down and also decrease on the colony diameter. Growth of molds in tube dilution was slow down significantly compared to control, which correspond to result of plate agar and hanging drop. Both isolates did not grow on the paint test which was added with ZnO, although the incubation time has been prolonged to more than 2 weeks."