Synergistic or Antagonistic Effects of Probiotics and Antibiotics- Alone or in Combination- on Antimicrobial-Resistant Pseudomonas aeruginosa Isolated from Burn Wounds

Abstract

Background: Bacterial burn infections are one of the serious infections and since their treatment with antibiotics is very difficult, infection control in such wounds is very important. Therefore, methods should be sought to enhance the effects of antibiotics and also reduce the resistance to them. It seems that probiotics have antimicrobial features and are effective in wound healing. Objectives: The current study aimed at evaluating and comparing the antimicrobial effects of antibiotics and probiotics, as well as their combination on bacterial burn infections. Methods: Thirty clinically resistant Pseudomonas aeruginosa species isolated from hospitalized patients with burn wounds were collected. Antibacterial activity of five antibiotics and 11 probiotic strains, and also their combination were evaluated by disk diffusion method. One-way ANOVA and Tukey post hoc test were used for data analysis. Results: It was found that the effect of inhibitory zone in combination use of tetracycline + a probiotic strain was more than using the antibiotic and probiotic alone. Also, the current study found that among the probiotics, Lactobacillus plantarum 299v had the highest effect, although not significant, on resistant P. aeruginosa. The current study explained that the inhibitory effect of L. plantarum 299v was significantly higher than that of ciprofloxacin (P = 0.009). In addition, antibacterial activity of gentamicin + L. salivarius (ES1) was significantly higher compared with that of gentamicin + L. routeri (P = 0.01). Conclusions: The current study explained that probiotics had a useful potential inhibitory effect on the growth of the pathogens. The study showed that in most cases, inhibitory zones of probiotics were greater than those of antibiotics as well as combination of antibiotic + probiotic. But, there was an exception in tetracycline, which had synergistic effect with probiotics. Conversely, in the cases of imipenem and chloramphenicol, addition of probiotics had antagonistic effects. Further studies are needed to describe different results. Therefore, it seems that the type of antibiotics and probiotics are important to create the synergistic or antagonistic effects.

Efficacy of Using Probiotics with Antagonistic Activity against Pathogens of Wound Infections: An Integrative Review of Literature

“…Four studies included supernatants or extracts produced by probiotic strains [67,69,71,74], whilst the other studies used live probiotic cultures. Eight studies included various monospecies probiotics, whilst six studies included multispecies probiotics [64,66,70,71,73,75]. Two studies from Table 1 [61,68] also included animal model experiments and are additionally noted in Table 2.…”

Antibacterial and Antibiofilm Activity of the Mixed Lactobacilli Against the Most Bacterial Etiology of Otitis Media

“…and ciprofloxacin against P. aeruginosa growth. Similarly, [31] showed in their study that there was a synergistic effect between antibiotics and probiotics. The synergistic reaction of Lactobacillus and antibiotics enhancing their antibacterial properties and restores its ability to destroy bacteria that have acquired resistance to it [32].…”

Using Probiotics as Supplementation for Helicobacter pylori Antibiotic Therapy

“…Substances metabolized by these strains may have the potential to act synergistically with antibiotics. In vitro experiments have shown that the combination of tetracycline and probiotic fermentation broth has greater antimicrobial effects against Pseudomonas aeruginosa clinical resistant strains than either tetracycline or probiotic fermentation broth does alone [94]. Yang et al conducted an antibacterial study on Clostridium difficile, and the results showed that Bifidobacterium breve YH68 cell-free supernatant can enhance the synergistic effect of antibiotics and weaken the antagonistic effect [95].…”