In VitroPotentiation of Ampicillin, Oxacillin, Norfloxacin, Ciprofloxacin, and Vancomycin by Sanguinarine Against Methicillin-ResistantStaphylococcus aureus

Abstract

Few new drugs are available against methicillin-resistant Staphylococcus aureus (MRSA), because MRSA has the ability to acquire resistance to most antibiotics, which consequently increases the cost of medication. The objective of this study is to evaluate the potentiation of sanguinarine (SN) with selected antibiotics (ampicillin [AC], oxacillin [OX], norfloxacin [NR], ciprofloxacin [CP], and vancomycin [VC]) against MRSA. Minimum inhibitory concentration was determined by using the broth microdilution method and the synergistic effect of AC, OX, NR, CP, and VC in combination with SN was examined by the checkerboard dilution test. The results of the checkerboard test suggested that all combinations exhibited some synergy, partial synergy, or additivity. None of the combinations showed an antagonism effect. The combination of SN plus CP exhibited maximum synergistic effect in 11/13 strains, followed by SN plus NR in 9/13 strains, and AC and OX in 7/13 strains each. The combination of SN with VC, however, mostly showed partial synergy in 11/13 strains. The time-kill assay showed that SN in combination with other antibiotics reduced the bacterial count by 10(2)-10(3) colony forming units after 4 h and to less than the lowest detectable limit after 24 h. Although in vivo synergy and clinical efficacy of SN cannot be predicted, it can be concluded that SN has the potential to restore the effectiveness of the selected antibiotics, and it can be considered in an alternative MRSA treatment.

Synergistic antibacterial activity of the combination of the alkaloid sanguinarine with EDTA and the antibiotic streptomycin against multidrug resistant bacteria

“…[21] Sanguinarine has already been combined with antibiotics and other antimicrobial natural products, and synergistic interactions have been reported. [10,17] In one of our previous studies, we combined sanguinarine with EDTA and vancomycin and got a promising dose reduction of vancomycin (eight-to 32-fold) against several multiresistant clinical isolates like E. coli, K. pneumoniae, A. baumannii and MRSA. Furthermore, the combination could restore the efficacy of vancomycin against vancomycin-resistant strains.…”

“…EDTA can disturb the permeability of the cell wall of bacteria by chelating of Ca ++ and Mg ++ cations, which are essential for the stability of the bacterial cell wall, especially of Gram‐negative bacteria [8]. Both sanguinarine and EDTA have already been successfully used in combination with antibiotics and other antimicrobial drugs [9,10]. The third drug in our study is the aminoglycoside antibiotic streptomycin, which targets protein synthesis by direct interaction with the small ribosomal subunit [11].…”

“…[8] Both sanguinarine and EDTA have already been successfully used in combination with antibiotics and other antimicrobial drugs. [9,10] The third drug in our study is the aminoglycoside antibiotic streptomycin, which targets protein synthesis by direct interaction with the small ribosomal subunit. [11] Streptomycin was the first drug used in the treatment of Mycobacterium tuberculosis and is preferred for treatment of relapses.…”

Therapeutic Strategies for Metabolic Diseases: Small‐Molecule Diacylglycerol Acyltransferase (DGAT) Inhibitors

“…[88,89] These natural products are isolated through a bioactivity-guided fractionation of the total plant extract. [88,89] These natural products are isolated through a bioactivity-guided fractionation of the total plant extract.…”

Enriching modern pharmacotherapy through synergy assessment for the combination of natural products and synthetic drugs

“…The use of two drugs in combination is a good alternative to slow the process of developing drug resistance and to restore the effectiveness of drugs that are no longer prescribed. Combination therapy is the most commonly recommended empirical treatment for bacterial infections in intensive care units, where monotherapy may not be effective against all potential pathogens, and for preventing the emergence of resistant mutant (Obiang-Obounou et al, 2011a).…”