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Planta Med 2023; 89(02): 168-182
DOI: 10.1055/a-1890-5559
Biological and Pharmacological Activity
Reviews

Herbal Products and Their Active Constituents Used Alone and in Combination with Antibiotics against Multidrug-Resistant Bacteria

Anna Herman 
1   Faculty of Health Sciences, Warsaw School of Engineering and Health, Warsaw, Poland
,
Andrzej P. Herman
2   Department of Genetic Engineering, The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, Jabłonna near Warsaw, Poland
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Abstract

The purpose of this review is to summarize the current knowledge acquired on herbal products and their active constituents with antimicrobial activity used alone and in combination with antibiotics against multidrug-resistant bacteria. The most promising herbal products and active constituents used alone against multidrug-resistant bacteria are Piper betle (methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, extended-spectrum beta-lactamase, Acinetobacter baumannii, Pseudomonas aeruginosa), Glycyrrhiza glabra (methicillin-resistant S. aureus, vancomycin-resistant Enterococcus, P. aeruginosa), and berberine (methicillin-resistant S. aureus, A. baumannii, P. aeruginosa), respectively. The synergistic effect of the combination of herbal products and their active constituents with antibiotics against multidrug-resistant bacteria are also described. These natural antibacterial agents can be promising sources of inhibitors, which can modulate antibiotic activity against multidrug-resistant bacteria, especially as efflux pump inhibitors. Other possible mechanisms of action of herbal therapy against multidrug-resistant bacteria including modification of the bacterial cell wall and/or membrane, inhibition of the cell division protein filamenting temperature sensitive Z-ring, and inhibition of protein synthesis and gene expression, all of which will also be discussed. Our review suggests that combination herbal therapy and antibiotics can be effectively used to expand the spectrum of their antimicrobial action. Therefore, combination therapy against multidrug-resistant bacteria may enable new choices for the treatment of infectious diseases and represents a potential area for future research.

Key words

herbal products - active constituents - multidrug-resistant bacteria - antibiotics - synergistic therapy

Supporting Information

    Botanical (genus, species, and family) and trivial names of plants are available as Supporting Information.

  • Supporting Information


Publication History

Received: 02 February 2022

Accepted after revision: 09 June 2022

Article published online:
22 August 2022

© 2022. Thieme. All rights reserved.

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