14The problem of bacterial resistance is becoming more and more serious, which 15 has become an urgent problem to be solved in human and veterinary. One approach to 16 control and delay bacterial resistance is combination therapy in which antibiotics are 17 given together with other antimicrobial or non-antimicrobial agents. Studies have 18 shown that flavonoids from Traditional Chinese medicine (TCM) possess a high level 19 of antibacterial activity against antibiotic resistant strains. The aim of this study was 20 to evaluate the antibacterial effects of a combined therapy of total flavonoids from 21 Ilex rotunda Thunb. and antibiotics against seven kinds of veterinary bacteria which 22 were multidrug resistance bacteria. A microdilution checkerboard method was used to 23 determine the minimal inhibitory concentrations of both types of antimicrobials, alone 24 and in combination. The fractional inhibitory concentration index was calculated and 25 used to classify observed collective antibacterial activity as synergistic, additive, 26 indifferent or antagonistic. 27 From the performed tests, the total flavonoids and antimicrobial agents were 28 combined to inhibit different multidrug-resistant bacteria, such as Escherichia coli, 29 Streptococcus, Pseudomonas aeruginosa, Enterococcus faecalis, Proteus vulgaris, 30 Staphylococcus aureus, Acinetobacter baumannii. For these bacteria, total flavonoids 31 from Ilex Rotunda Thunb. presented synergistic or additive with different antibiotics 32 and had a certain antibacterial effect on the separated multidrug-resistant bacteria. The 33 study shows total flavonoids from Ilex rotunda Thunb. have potential as adjuvants for 34 the treatment of animal bacterial diseases.35
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