Abstract
Given the increasing antimicrobial resistance in urinary tract infections (UTI), alternative strategies need to be investigated. Determination of minimal inhibitory and bactericidal concentrations of essential oils from cajeput, lemongrass, tea tree, and thyme in artificial urine, revealed bactericidal activity of all four tested essential oils against seven uropathogenic species with values ranging between 0.78–50 mg/mL. Tea tree and thyme essential oils were more efficient than lemongrass and cajeput. In addition, antibiotic-resistant strains showed similar susceptibility as antibiotic-sensitive strains, suggesting no cross-resistance between antibiotics and these essential oils. Checkerboard assays revealed a synergistic activity of the combination of thyme and tea tree. Furthermore, the combination with thyme and tea tree essential oils increased the activity of fosfomycin and pivmecillinam, but not nitrofurantoin, against Escherichia coli. This study provides a basis for further investigation of the potential of thyme and tea tree oil as an alternative or additional treatment of UTI.
Highlights
Uncomplicated urinary tract infections (UTI), which are caused predominantly by Escherichia coli and by Staphylococcus saprophyticus, Proteus mirabilis, and Klebsiella spp. and other Enterobacteriaceae, are amongst the most common reasons for medical consultation [1]
To further test whether essential oils could be beneficial for UTI treatment, we examined the effects of the combination of thyme and tea tree with three of the guideline-recommended antibiotics for the treatment of uncomplicated lower UTIs—fosfomycin, nitrofurantoin, and pivmecillinam [2]
P. aeruginosa showed the least susceptibility, which corresponds to previous studies [7,15]
Summary
Uncomplicated urinary tract infections (UTI), which are caused predominantly by Escherichia coli and by Staphylococcus saprophyticus, Proteus mirabilis, and Klebsiella spp. and other Enterobacteriaceae, are amongst the most common reasons for medical consultation [1]. For the treatment of mild and moderate uncomplicated UTI, oral antibiotics are preferred [2]. Due to the increasing rates of resistance of uropathogens against cotrimoxazole, fluoroquinolones, and β-lactams, these classical oral antibiotics cannot be used for empiric therapy any more in many geographic regions [3,4]. To counteract the increasing resistance rates, alternative treatment options, such as phytotherapeutic approaches, need to be investigated. Various essential oils have been reviewed to possess different biological properties such as anti-inflammatory, sedative, digestive, antimicrobial, antiviral, or antioxidant activities [5]. Direct killing as well as sensitizing activities against microbes have been reported for essential oils [5,6,7].
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