Abstract
Combinatory therapies have been commonly applied in the clinical setting to tackle multi-drug resistant bacterial infections and these have frequently proven to be effective. Specifically, combinatory therapies resulting in synergistic interactions between antibiotics and adjuvant have been the main focus due to their effectiveness, sidelining the effects of additivity, which also lowers the minimal effective dosage of either antimicrobial agent. Thus, this study was undertaken to look at the effects of additivity between essential oils and antibiotic, via the use of cinnamon bark essential oil (CBO) and meropenem as a model for additivity. Comparisons between synergistic and additive interaction of CBO were performed in terms of the ability of CBO to disrupt bacterial membrane, via zeta potential measurement, outer membrane permeability assay and scanning electron microscopy. It has been found that the additivity interaction between CBO and meropenem showed similar membrane disruption ability when compared to those synergistic combinations which was previously reported. Hence, results based on our studies strongly suggest that additive interaction acts on a par with synergistic interaction. Therefore, further investigation in additive interaction between antibiotics and adjuvant should be performed for a more in depth understanding of the mechanism and the impacts of such interaction.
Highlights
Antimicrobial resistance is an ongoing challenge in the clinical setting at present, mainly due to a lack of compliance by patients and health practitioners, coupled with extensive and overuse of antibiotics in the agriculture and aquaculture sectors [1]
In order to further investigate the effects of additivity in combinatory therapy, cinnamon bark essential oil (CBO) and meropenem combination was selected based on the highest FICIc as a good representation of additivity in subsequent assays
Our study showed that additivity and synergistic interaction between CBO and antibiotic were comparable in their ability to cause bacterial membrane disruption, via comparison with similar studies carried out previously
Summary
Antimicrobial resistance is an ongoing challenge in the clinical setting at present, mainly due to a lack of compliance by patients and health practitioners, coupled with extensive and overuse of antibiotics in the agriculture and aquaculture sectors [1]. This phenomenon has triggered the Molecules 2017, 22, 1733; doi:10.3390/molecules22111733 www.mdpi.com/journal/molecules. Antibiotic-antibiotic combination involves the use of different classes of antibiotics, with the most common combinations being β-lactams and aminoglycosides or fluoroquinolone This combinatory treatment is not recommended as it would worsen the issue of antibiotic resistance in bacteria [4]. The second option, involves the use of an adjuvant, a compound which, when administered alone has minimal or no antimicrobial activity, but increases the effectiveness of the antibiotic synergistically when used in combination as a whole
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