Potential of Herbal Drug and Antibiotic Combination Therapy: A New Approach to Treat Multidrug Resistant Bacteria (original) (raw)
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Pharmacognosy Reviews
The discovery of penicillin nearly 90 years ago revolutionized the treatment of bacterial disease. Since that time, numerous other antibiotics have been discovered from bacteria and fungi, or developed by chemical synthesis and have become effective chemotherapeutic options. However, the misuse of antibiotics has lessened the efficacy of many commonly used antibiotics. The emergence of resistant strains of bacteria has seriously limited our ability to treat bacterial illness, and new antibiotics are desperately needed. Since the discovery of penicillin, most antibiotic development has focused on the discovery of new antibiotics derived from microbial sources, or on the synthesis of new compounds using existing antibiotic scaffolds to the detriment of other lines of discovery. Both of these methods have been fruitful. However, for a number of reasons discussed in this review, these strategies are unlikely to provide the same wealth of new antibiotics in the future. Indeed, the number of newly developed antibiotics has decreased dramatically in recent years. Instead, a reexamination of traditional medicines has become more common and has already provided several new antibiotics. Traditional medicine plants are likely to provide further new antibiotics in the future. However, the use of plant extracts or pure natural compounds in combination with conventional antibiotics may hold greater promise for rapidly providing affordable treatment options. Indeed, some combinational antibiotic therapies are already clinically available. This study reviews the recent literature on combinational antibiotic therapies to highlight their potential and to guide future research in this field.
Nowadays, multiple antibiotic resistance by disease-causing microorganisms are a major public health problem. Antimicrobial compounds from plants have been found to be synergistic enhancers in that though they may not possess any antimicrobial properties alone, but when used concurrently with standard drugs they enhance the activity of the drug. The synergistic effect of the association of antibiotic and plant extracts against resistant pathogens leads to new choices for the treatment of infectious diseases. Also synergy between bioactive plant product and antibiotics will confront problems of toxicity and overdose since lesser concentrations of two agents in combination are required, due to these reasons, there is need therefore, for continuous exploration of multidrug resistance modulating principles from plants sources.
A total of eighty bacterial isolates were isolated from pus, sputum, blood, stool and urine of different patients admitted to Sidnawy Hospital, Zagazig University, Egypt. These bacterial isolates were distributed as 50 Gram negative bacterial isolates (62.5%) and 30 Gram positive bacterial isolates (37.5%). The antibiotic susceptibility showed that the most effective antibiotic was amikacin followed by nitrofurantoin, norfloxacin, streptomycin and ciprofloxacin with 80%, 76.25%, 71.25%, 70% and 60% susceptibility respectively. On the other hand, 87.5% of bacterial isolates were resistant to aztreonam while 77.5% and 67.5% were resistant to clindamycin and oxacillin respectively. The four tested isolates; Escherichia coli 3, Staphylococcus aureus 20, Pseudomonas aeruginosa 58 and Klebsiella pneumoniae 65 were selected as multi-drug resistant (MDR) isolates against the tested antibiotics. Identification of the four selected isolates was confirmed molecularly by investigation of 16S rRNA gene sequences. The minimum inhibitory concentrations (MICs) of the most three effective antibiotics; amikacin, nitrofurantoin and norfloxacin were determined against the four multi-drug resistant(MDR) isolates. Furthermore, a total of 488 methanolic and aqueous crude extracts derived from different parts of 235 medicinal plant species traditionally used in Egyptian folk medicine belonging to 209 genera and 88 botanical families, were screened for their antibacterial activity against the highly resistant bacterial isolates. Out of 235 tested plants, 30 plant species belonging to 21 botanical families showed highly significant antibacterial activity by inhibiting all tested MDR isolates, and were more effective against Gram-positive than Gram-negative isolates. The microorganisms' susceptibility to different extracts did not correlate with the susceptibility or resistance to particular antibiotics. In most cases the organic extracts (80% methanol, 80% ethanol, 80% butanol, acetone, petroleum ether or chloroform) showed the same or greater activity than the aqueous extracts. Also, the methanolic extracts showed the strongest and broadest spectrum. The combination between the most potent plant extracts (Rhus coriaria, Acacia nilotica or Tamarindus indica) and antibiotics (amikacin, norfloxacin, vancomycin, tetracycline or amoxycillin) showed synergistic effect against the tested bacteria than each of them alone. [EL-Zawahry, Y. A.; Reda, F. M. and Azazy, W. M. Synergistic Effects of Combination Treatment between Certain Plant Extracts and Some Antibiotics on the Resistance of Pathogenic Bacteria against Some Common Antibiotics. Life Sci J 2013;10(4):3477-3489]. (ISSN:1097-8135). http://www.lifesciencesite.com. 463
2020
The advent of antibiotics revolutionized medical care resulting in significantly reduced mortality and morbidity caused by infectious diseases. However, excessive use of antibiotics has led to the development of antibiotic resistance and indeed, the incidence of multidrug‐resistant pathogens is considered as a major disadvantage in medication strategy, which has led the scholar's attention towards innovative antibiotic sources in recent years. Medicinal plants contain a variety of secondary metabolites with a wide range of therapeutic potential against the resistant microbes. Therefore, the aim of this review is to explore the antibacterial potential of traditional herbal medicine against bacterial infections. More than 200 published research articles reporting the therapeutic potential of medicinal plants against drug‐resistant microbial infections were searched using different databases such as Google Scholar, Science Direct, PubMed and the Directory of Open Access Journals (D...
Malaysian Journal of Microbiology, 2015
Aims: To evaluate the possible in vitro interaction between methanolic extract of root of Adiantumcapillus-veneris and certain known antimicrobial drugs i.e. Oxacillin, Ceftazimide, Cefriaxone, Ofloxacin, Meropenem, Erythromycin, Cefuroxime, Cefoxitin, Cefotaxime and Ampicillin. Methodology and results: The study was carried out against ten bacterial strains (Staphylococcus aureus, S. epidermidis, Salmonella typhi, Klebsiella pneumoniea, Shigella dysentriea, Proteus vulgaris, Pseudomonas aeruginosa, Providencia species, Citrobacter freundii and Escherichia coli isolated from urine, pus and blood samples. Both disc diffusion and well diffusion methods were used to determine antimicrobial activity of plant extract in combination with antibiotics. Antimicrobial sensitivity showed that Meropenem was the most effective antibiotic with zone of inhibition (ZI) of 25-33 mm among all tested antibiotics followed by Ofloxacin (10-26.5 mm), Ceftriaxone (8-20 mm), while Oxacillin showed no activity against almost all bacterial strains. The study showed that most bacterial strains were resistant to most of the antibiotics used, ranging from 20-60%. The methanolic extract (mEXT) of A. capillus-veneris used alone was active against most of the bacterial isolates with maximum activity against E. coli with 16 mm ZI. The study also indicated that there was an increased activity in case of combination of mEXT with antibiotics. The combined effects of plant extract with antibiotics were synergistic against most of the bacterial strains. The mEXT showed maximum synergistic effect with Ceftazimide with ZI of 42 mm followed by Meropenem (40 mm) and Ceftriaxone (28 mm) against multidrug-resistant (MDR) bacterial strains. Conclusion, significance and impact of study: The data suggests that plant extract could be used as alternative to antibiotics. These results give scientific backing that combination between plant extract and antibiotics would be useful in fighting the emerging drug-resistant bacterial pathogens.
Bacterial Pathogenesis and Antibacterial Control
The alarming growth of the number of antibiotic resistant bacteria and difficulties in treatment of infections have initiated a search for new antibacterial compounds and develop new alternative strategies in combating bacterial infections. Plant-derived compounds could exhibit a direct antibacterial activity and/or an indirect activity as antibiotic resistance modifying compounds, which, combined with antibiotics, increase their effectiveness. This ability of plant active substances reflects in modification or blocking of resistance mechanism so that bacterium becomes sensitive to antibiotic or the antibiotic acts when in lower concentrations. The systematic screening of plant-derived bioactive compounds, including those which can synergistically act with antibiotics, as resistance modifying agents represents a potential approach to overcome bacterial resistance. Therefore, the goals of this chapter are (i) an update of literature review on synergism between plant extracts and antibiotics, (ii) presentation of experimental results of synergistic activity of selected plant extracts and antibiotics and (iii) concluding remarks.
Alternative to Antibiotics from Herbal Origin – Outline of a Comprehensive Research Project
Current Pharmacogenomics and Personalized Medicine (Formerly Current Pharmacogenomics) , 2018
Background: The presently practiced procedure of development of new antimicrobial substances to control infection of the pathogenic microbes is now at a point of challenge and threat for losing relevancy in near future. Objective: Exploration of Herbal source for searching alternative to the antibacterial substances. Method: Through thorough literature survey, a list of 1060 plants with reported use among various communities throughout the globe in the purposes related with combating and controlling different types of infection has been identified. An outline of research on the plants for validation of the traditional claims by conventional antimicrobial, antioxidant and immunostimulant activity study and identification of phytochemicals is added. Limitation of the contemporary systems are discussed with a proposal of addition of fresh extract of succulent plant parts of listed medicinal plants along with conventional solvent extracted portion of dry plant parts as another parameter of study. Result: A comprehensive research proposal for study on the medicinal plants which may act in some way as alternative to the present system of use of synthetic antimicrobial substances to control diseases of infective origin with a detail guideline for production, storage and global transport of succulent bio-medicines are discussed. Conclusion: Following the way of proposed thorough research, a new type of herbal medicine based treatment system may be started and an opportunity for establishment of export oriented agro-medicine industries may be created. DOI:10.2174/1875692116666180419154033. “The published manuscript is available at EurekaSelect viahttp://www.eurekaselect.com/openurl/content.php?genre=article&doi=\[10.2174/1875692116666180419154033\].”
The outcome of in vitro interaction of standard antibiotics with ethanolic leaf extracts of three medicinal plants (Picralima nitida, Chromolaena odorata and Aspilia africana) against antibiotic resistant bacteria was investigated by agar disc diffusion methods and macrobroth dilution techniques. At least three isolates each of Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa that were resistant to more than two of the following antibiotic discs were used: erythromycin, chloramphenicol, tetracycline, norfloxacin and ciprofloxacin. A subinhibitory concentration (1/4th MIC) of the plant extracts were combined with the antibiotics against the resistant bacteria isolates using both antibiotic disc diffusion technique and macrobroth dilution test. The extract of A. africana enhanced the activities of the test antibiotics (except erythromycin) against resistant E. coli, and also enhanced the activities of ciprofloxacin, norfloxacin and chloramphenicol against antibiotic resistant P. aeruginosa. It also enhanced the activities of tetracycline and norfloxacin against antibiotic resistant S. aureus. The extract of C. odorata greatly enhanced the activities of the antibiotics (except erythromycin) against the resistant P. aeruginosa and also potentiated the activities of chloramphenicol and tetracycline against resistant S. aureus. Although the extract of P. nitida potentiated few antibiotics such as tetracycline and chloramphenicol against resistant E. coli, the extract exhibited high levels of antagonism with ciprofloxacin and norfloxacin against almost all the test bacteria. These results suggest that extracts of C. odorata and A. africana could be good sources of multidrug resistance inhibitors, and indicate that indiscriminate co-administration of antibiotics with some herbal drugs such as those from P. nitida could be therapeutically wasteful. Their use in combination with conventional antibiotics should be further studied for in vivo activities. This may lead to the development of much needed drug enhancing preparations.
Synergistic effects of natural products and commercial antibiotics
2020
Context: The antimicrobial resistant era requires advances in the approaches and technologies to find new treatments. The enhancement of the antimicrobial activity of commercially available drugs (CADs) by natural products (NPs) has successful mixtures (e.g., clavulanic acid and amoxicillin). Objective: To systematically review reports of synergistic effects of CADs and NPs against opportunistic microbial strains from 2010 to April 2016. Methods: The databases and search engines PubMed, Medline, Scifinder, Scopus, ScienceDirect, Scholar Google were systematically searched. Among the keywords utilized were: synergistic effects natural products and antibioitcs, botanicals and antibiotics bioassays, plant extracts interaction with antibioitics and antibiotic adjuvant bioassays. Only synergistic results were tabulated and analyzed according to CADs, NPs and strains. Results: A set of 76 studies that reported in vitro synergistic effects of CADs and NPs against gram−positive or gram−nega...
ANTIMICROBIAL POTENTIAL OF HERBAL MEDICINES
ABSTRACT Herbal medicines are widely used since time immemorial indicating that herbs are a growing part of modern, high-tech medicine. India has an ancient heritage of traditional herbal medicine. The World Health Organization estimates that about 80% of the populations living in the developing countries rely almost exclusively on traditional medicine for their primary health care needs. The use of herbal drugs for treating various diseases predates human history forms the origin of much of the modern medicine.