Evaluation of Levofloxacin and Yahom-Navakot Remedy Extract Combination Therapy Against Antibiotic Resistant Bacteria In Vitro
Keywords:
Yahom-Navakot remedy, Levofloxacin, Bacterial antibiotic resistance, Antibacterial activitiesAbstract
Introduction: Antibiotic resistant bacteria are being considered a serious public health challenge. Levofloxacin is a broad-spectrum antibiotic, developed to replace previously resistant antimicrobials. The use of natural products as an antimicrobial drug is an alternative way to reduce bacterial resistance by synthesized drugs and enhance their efficacy. Yahom-Navakot (YN) is a Thai remedy in the Thai essential drug list. The indications for YN treatment are to relieve fatigue, dizziness, malaise, and vomiting after alleviation of fever. Previous studies have reported antibiotic enhancing effects of YN. This study was aimed to evaluate the antibacterial activities of levofloxacin and Yahom-Navakot Remedy Extract.
Methods: YN remedy was macerated with 95% ethanol, after solvent evaporation the extract was combined with levofloxacin (1:1). By using modified resazurin in the broth micro-dilution assay, the antibacterial activities of the combination were evaluated against the pathogenic bacteria; Staphylococcus aureus (DMST 20651), Methicillin-Resistant Staphylococcus aureus (ATCC 25923), Staphylococcus epidermidis (ATCC 12228), Pseudomonas aeruginosa (ATCC 27853), Klebsiella pneumoniae (ATCC BAA 2789), Salmonella typhi (DMST 22842), Shigella dysenteriae (DMST 15111), and Escherichia coli (ATCC 25922). P. aeruginosa, MRSA, S. typhi, S. dysenteriae, and E. coli were antibiotic resistant bacteria strains according to WHO criteria. Levofloxacin was used as a control in this study.
Results: In vitro YN extract showed potent antibacterial effect against S. aureus (MIC = 0.625, MBC = 0.39 mg/mL), MRSA (MIC = 0.625, MBC = 25 mg/mL), and S. epidermidis (MIC = 0.3125, MBC = 50 mg/mL). YN extract (At MICs against selected bacteria strains) demonstrated enhanced antibacterial activities of levofloxacin against MRSA (MIC < 3×10-8, MBC < 3×10-8 µg/mL) and S. epidermidis (MIC = 0.048, MBC = 25 µg/mL) as determined by reduced MICs and MBCs. However, it did not affect other selected bacteria strains; P. aeruginosa, K. pneumoniae, S. typhi, S. dysenteriae, and E. coli (MIC > 5 mg/mL).
Conclusions: YN showed evidence of antibacterial activity. It had potential antibiotic enhanced activity with levofloxacin; however, further in vivo and clinical studies are essential to evaluate YN’s efficacy and safety.
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References
Ventola CL. The antibiotic resistance crisis: part 1: causes and threats. P T. 2015;40 (4):277-83.
Siddiqui AH, Koirala J. Methicillin Resistant Staphylococcus aureus. Treasure Island (FL): StatPearls Publishing; 2021.
Hassoun A, Linden PK, Friedman B. Incidence, prevalence, and management of MRSA bacteremia across patient populations-a review of recent developments in MRSA management and treatment. Crit Care. 2017;21(1):211. doi:
1186/s13054-017-1801-3. 4. Kock R, Becker K, Cookson B, et al. Methicillin-resistant Staphylococcus aureus (MRSA): burden of disease and control challenges in Europe. Euro surveillance. 2010;15(41):19688.
Jaganath D, Jorakate P, Makprasert S, et al. Staphylococcus aureus Bacteremia Incidence and Methicillin Resistance in Rural Thailand, 2006-2014. The American journal of tropical medicine and hygiene. 2018;99(1):155-163.
Waitayangkoon P, Thongkam A, Benjamungkalarak T, et al. Hospital epidemiology and antimicrobial susceptibility of isolated methicillin-resistant Staphylococcus aureus: a one-year retrospective study at a tertiary care center in Thailand. Pathogens and global health. 2020;114(4):212-217.
Podder V, Sadiq NM. Levofloxacin. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK545180/. Updated September 20, 2020. Accessed 2021.
Fu KP, Lafredo SC, Foleno B, et al. In vitro and in vivo antibacterial activities of levofloxacin (l-ofloxacin), an optically active ofloxacin. Antimicrob Agents Chemother. 1992; 36(4):860-866.
Blondeau JM. A review of the comparative in vitro activities of 12 antimicrobial agents, with a focus on five new ‘respiratory quinolones’. Journal of Antimicrobial Chemotherapy. 1999;43(S2):1-11.
Antibiotic resistance. World Health Organization. https://www.who.int/news-room/factsheets/detail/antibiotic-resistance. Accessed December 11, 2020.
Hemaiswarya S, Kruthiventi AK, Doble M. Synergism between natural products and antibiotics against infectious diseases. Phytomedicine. 2008;15(8):639-652.
Cai Y, Zhang Q, Fu Y, et al. Effectiveness of Chinese Herbal Medicine Combined with Antibiotics for Extensively Drug-Resistant Enterobacteria and Nonfermentative Bacteria Infection: Real-Life Experience in a Retrospective Cohort. BioMed Research International. 2017;2017:2897045.
Olajuyigbe OO, Afolayan AJ. Evaluation of Combination Effects of Ethanolic Extract of Ziziphus mucronata Willd. subsp. Mucronata Willd. and Antibiotics against Clinically Important Bacteria. The Scientific World Journal. 2013;2013:769594.
Dudhatra GB, Mody SK, Awale MM, et al. A comprehensive review on pharmaco-therapeutics of herbal bioenhancers. Scientific World 236 Asian Medical Journal and Alternative Medicine Journal. 2012;2012:637953.
Sarker SD, Nahar L, Kumarasamy Y. Microtitre plate-based antibacterial assay incorporating resazurin as an indicator of cell growth, and its application in the in vitro antibacterial screening of phytochemicals. Methods (San Diego, Calif). 2007;42(4):321-324.
Chanda S, Rakholiya K. Combination therapy: Synergism between natural plant extracts and antibiotics against infectious diseases. Science against Microbial Pathogens: Communicating Current Research and Technological Advances. 2011.
Heep M, Rieger U, Beck D, Lehn N. Mutations in the beginning of the rpoB gene can induce resistance to rifamycins in both Helicobacter pylori and Mycobacterium tuberculosis. Antimicrob Agents Chemother. 2000;44(4):1075-1077.
Renau TE, Leger R, Flamme EM, et al. Inhibitors of Efflux Pumps in Pseudomonas aeruginosa Potentiate the Activity of the Fluoroquinolone Antibacterial Levofloxacin. Journal of Medicinal Chemistry. 1999;42(24):4928-4931.
Wright GD. Bacterial resistance to antibiotics: Enzymatic degradation and modification. Advanced Drug Delivery Reviews. 2005;
(10):1451-1470.
Nikaido H. Molecular Basis of Bacterial Outer Membrane Permeability Revisited. Microbiology and Molecular Biology Reviews. 2003;67(4):593.
Vazquez-Fresno R, Rosana ARR, Sajed T, Onookome-Okome T, Wishart NA, Wishart DS. Herbs and Spices-Biomarkers of Intake Based on Human Intervention Studies-A Systematic Review. Genes Nutr. 2019;14:18.
Liang X, Li B, Wu F, et al. Bitterness and antibacterial activities of constituents from Evodia rutaecarpa. BMC Complement Altern Med. 2017;17(1):180.
Diao WR, Zhang LL, Feng SS, Xu JG. Chemical composition, antibacterial activity, and mechanism of action of the essential oil from Amomum kravanh. Journal of food protection. 2014;77(10):1740-1746.
Kaur G, Arora DS. Antibacterial and phytochemical screening of Anethum graveolens, Foeniculum vulgare, and Trachyspermum ammi. BMC complementary and alternative medicine. 2009;9:30.
Yang WT, Ke CY, Wu WT, Tseng YH, Lee RP. Antimicrobial and anti-inflammatory potential of Angelica dahurica and Rheum officinale extract accelerates wound healing in Staphylococcus aureus-infected wounds. Scientific Reports. 2020;10(1):5596.
Han C, Guo J. Antibacterial and anti-inflammatory activity of traditional Chinese herb pairs, Angelica sinensis and Sophora flavescens. Inflammation. 2012;35(3):913-919.
Kim WS, Choi WJ, Lee S, et al. Anti-inflammatory, Antioxidant and Antimicrobial Effects of Artemisinin Extracts from Artemisia annua L. Korean J Physiol Pharmacol. 2015;19(1):21-27.
He F, Wang W, Wu M, et al. Antioxidant and antibacterial activities of essential oil from Atractylodes lancea rhizomes. Industrial Crops and Products. 2020;153:112552.
Helmi H, Susanti I, Agung N, Kusen S. Antibacterial activity of belilik (Brucea javanica (L). merr) and benta (Wikstroemia androsaemofolia decne) to inhibit the growth of enteropathogenic bacteria. Journal of Biological Researches. 2016;21:35-40.
Atiphasaworn P, Monggoot S, Pripdeevech P. Chemical composition, antibacterial and antifungal activities of Cinamomum bejolghota bark oil from Thailand. Journal of Applied Pharmaceutical Science. 2017;7:69-73.
Keloth S, Krishnamurthy K, Janardhanan J, Azeez S. Antimicrobial properties in bark and leaf extracts of four Cinnamomum species.
Journal of Evolution of Medical and Dental Sciences. 2018;7:683-689.
Sambasivaraju D, Za F. Evaluation of antibacterial activity of Coriandrum sativum (L.) against gram and positive and gram negative
bacteria. International Journal of Basic and Clinical Pharmacology. 2016;5:2653-2656.
Dua A, Gaurav G, Singh B, Mahajan R. Antimicrobial properties of methanolic extract of cumin (Cuminum cyminum) seeds. International Journal of Research in Ayurveda and Pharmacy. 2013;4:104-107.
Khalid K, Shnawa B, Abdullah S. Antimicrobial Activity of Cyperus rotundus Linn. Extracts and Phytochemical Screening. Eurasian Journal of Science and Engineering. 2017;3.
Al Zubairi AS, Abdul AB, Abdelwahab SI, Peng CY, Mohan S, Elhassan MM. Eleucine indica Possesses Antioxidant, Antibacterial and Cytotoxic Properties. Evid Based Complement Alternat Med. 2011;2011:965370.
Diao WR, Hu QP, Zhang H, Xu JG. Chemical composition, antibacterial activity and mechanism of action of essential oil from seeds
of fennel (Foeniculum vulgare Mill.). Food Control. 2014;35(1):109-116.
Nitalikar M, Munde K, Dhore B, Sajid N. Studies of Antibacterial Activities of Glycyrrhiza glabra Root Extract. International Journal of PharmTech Research. 2010;2.
Rath CC, Devi S, Dash SK, Mishra RK. Antibacterial potential assessment of jasmine essential oil against E. coli. Indian J Pharm
Sci. 2008;70(2):238-241.
Rao N, Dowluru KS. Antioxidant and antimicrobial activities of rhizome extracts of Kaempferia galanga.World J Pharma Pharma Sci. 2014;3:1180-1189.
Alqahtani FY, Aleanizy FS, Mahmoud AZ, et al. Chemical composition and antimicrobial, antioxidant, and anti-inflammatory activities of Lepidium sativum seed oil. Saudi Journal of Biological Sciences. 2019;26(5):1089-1092.
Wang J, Xu L, Yang L, Liu Zl, Zhou L. Composition, antibacterial and antioxidant activities of essential oils from Ligusticum sinense and L. jeholense (Umbelliferae) from China. Records of Natural Products. 2011;5:314-318.
Subhadhirasakul S, Pharkphoom P. A terpenoid and two steroids from the lowers of Mammea siamensis. Songklanakarin Journal of Science and Technology. 2005;27.
Mazumder R, Dastidar SG, Basu SP, Mazumder A, Singh SK. Antibacterial potentiality of Mesua ferrea Linn. flowers. Phytotherapy research: PTR. 2004;18(10):824-826.
Mandal S, Sircar B. Antibacterial Activity of Mimusops Elengi Leaf, Seed and Bark Extracts Alone and in Combination with Antibiotics against Human Pathogenic Bacteria. Translational Medicine. 2016;06.
Shafiei Z, Shuhairi NN, Md Fazly Shah Yap N, Harry Sibungkil CA, Latip J. Antibacterial Activity of Myristica fragrans against Oral Pathogens. Evidence-Based Complementary and Alternative Medicine. 2012;2012:825362.
Gupta AD, Bansal VK, Babu V, Maithil N. Chemistry, antioxidant and antimicrobial potential of nutmeg (Myristica fragrans Houtt). Journal of Genetic Engineering and Biotechnology. 2013;11(1):25-31.
Dechayont B, Phuaklee P, Chunthorng-Orn J, et al. Antimicrobial, Anti-inflammatory, and Antioxidant Activities of the Wood of Myristica fragrans. Journal of Herbs, Spices & Medicinal Plants. 2019;26:1-12.
Pn R, S M. In vitro antibacterial activity of ethanolic extract of seedpod and quercetin of Nelumbo nucifera Gaertn. Asian Journal of Pharmaceutical and Clinical Research. 2019;12(1):164-167.
Ugur AR, Dagi HT, Ozturk B, Tekin G, Findik D. Assessment of In vitro Antibacterial Activity and Cytotoxicity Effect of Nigella sativa Oil. Pharmacogn Mag. 2016;12(S4):471-474.
Khan DA, Hassan F, Ullah H, et al. Antibacterial activity of Phyllantus emblica, Coriandrum sativum, Culinaris medic, Lawsonia alba, and Cucumis sativus. Acta Poloniae Pharmaceutica. 2013;70(5):855-859.
Rathee D, Rathee P, Rathee S, Rathee D. Phytochemical screening and antimicrobial activity of Picrorrhiza kurroa, an Indian traditional plant used to treat chronic diarrhea. Arabian Journal of Chemistry. 2016;9:1307-1313.
Amer A, Aly U. Antioxidant and antibacterial properties of anise (Pimpinella anisum L.). Egyptian Pharmaceutical Journal. 2019;18(1):68-73.
Singh C, Rai NP. In vitro antibacterial activity of Piper longum L. fruit. International Journal of Pharmaceutical Sciences Review and Research. 2013;18:89-91.
Salleh WMNHW, Farediah A, Khong HY. Chemical Composition of Piper stylosum Miq. and Piper ribesioides Wall. Essential Oils and their Antioxidant, Antimicrobial and Tyrosinase Inhibition Activities. Boletin Latinoamericano y del Caribe de Plantas Medicinales y Aromaticas. 2014;13:488-497.
Chanprapai P, Chavasiri W. Antimicrobial activity from Piper sarmentosum Roxb. against rice pathogenic bacteria and fungi. Journal of Integrative Agriculture. 2017;16(11):2513-2524.
Ghahtan N. Antibacterial effect of Plantago ovata and Lallemantia iberica seed extracts against Some Bacteria. Res Mol Med. 2017;5(3):32-36.
Saha D, Paul S. Antibacterial activity of Plumbago indica. Turk J Pharm Sci. 2014;11:217-222.
Dechayont B, Ruamdee P, Poonnaimuang S, Mokmued K, Chunthorng-Orn J. Antioxidant and Antimicrobial Activities of Pogostemon cablin (Blanco) Benth. Journal of Botany. 2017;2017:1-6.
Mostaqim S, Saha SK, Hani U, et al. Antibacterial Activities of Clove (Syzygium aromaticum) Extracts Against Three Food Borne Pathogens: Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Mymensingh Med J. 2019;28(4):779-791.
Dharmaratne P, Amirthasingam M, Thevanesam V, et al. Terminalia bellirica fruit extracts: In-vitro antibacterial activity against selected multidrug-resistant bacteria, radical scavenging activity and cytotoxicity study on BHK-21 cells. BMC Complement Altern Med. 2018;18.
Shankara BE, Ramachandra YL, Rajan S, Preetham J, Ganapathy S. In vitro antibacterial activity of Terminalia chebula leaf gall extracts against some human pathogenic strains. International Current Pharmaceutical Journal. 2012;1.
Iqbal CM, Gunjan M, Kumar Chellappan D. Antimicrobial activity of Tinospora crispa root extracts. International Journal of Research in Ayurveda and Pharmacy. 2012;3:417-419.
Hassanshahian M, Bayat Z, Saeidi S, Shiri Y. Antimicrobial activity of Trachyspermum ammi essential oil against human bacterial. International Journal of Advanced Biological and Biomedical Research. 2014;2:18-24.
Dahiya DD, Srinivasan KK, Subburaju T, Singh S. Antimicrobial activity of alcoholic and aqueous extracts of Vetiveria zizanioides. J Pharm Res. 2011;4:1343-1344.
Malu S, Obochi G, Tawo E, Nyong B. Antibacterial activity and medicinal properties of Ginger (Zingiber officinale). Global Journal of Pure and Applied Sciences. 2009;15.
Tatiraju D, Bagade V, Karambelkar P, Jadhav V, Kadam V. Natural bioenhancers: an overview. J Pharmacog Phytochem. 2013;2:55-60.
Ali B, Amin S, Ahmad J, Ali A, Mohd A, Mir SR. Bioavailability enhancement studies of amoxicillin with Nigella. Indian J Med Res.
;135(4):555-559.
Ibrahim MK, Mattar ZA, Abdel Khalek HH, Azzam YM. Evaluation of antibacterial efficacy of anise wastes against some multidrug resistant bacterial isolates. Journal of Radiation Research and Applied Sciences. 2017;10(1):34-43.
Mun SH, Kang OH, Joung DK, et al. Combination Therapy of Sophoraflavanone B against MRSA: In Vitro Synergy Testing. Evid Based
Complement Alternat Med. 2013;2013:823794.
Vazirian M, Hamidian K, Noorollah M, Manayi A, Samadi N. Enhancement of Antibiotic Activity and Reversal of Resistance in Clinically Isolated Methicillin-Resistant Staphylococcus aureus by Trachyspermum ammi Essential Oil. Research Journal of Pharmacognosy. 2019;6(1):1-10.
Chanda S, Rakholiya K. Combination therapy: Synergism between natural plant extracts and antibiotics against infectious diseases. Science against Microbial Pathogens: Communicating Current Research and Technological Advances.2011;520-529.
Global priority list of antibiotic resistant bacteria to guide research, discovery, and development of new antibiotics. World Health Organization. https://www.who.int/medicines/publications/WHO-PPL-Short_Summary_25Feb-ET_NM_WHO.pdf. Published 2017. Accessed July 19, 2021.
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