Apple Cider Vinegar Potential as an Adjuvant Therapy Breakthrough against Antibiotic Resistant Bacteria

Abstract

Introduction: One of the medical emergencies worldwide is antibiotic resistance caused by the irrational use of antibiotics. This issue increases the mortality and morbidity rates and challenges in selecting the appropriate therapeutic regimen in bacterial infection cases. Solution inquiry is still being conducted, including the research and development of new antibiotics. However, there is still an imbalance between the pacing rate of new antibiotic discovery and the emergence of the antibiotic resistance problem, so that currently, there are plenty of studies on alternative therapies. Apple cider vinegar (ACV) is a fermented fruit product that has been shown to have antimicrobial effects. Methods: This review article was composed by conducting a journal search with the keywords "antibiotic resistance", "apple cider vinegar", and "antimicrobial". Among 39 journals that have been reviewed, 30 were found to be suitable as references for this article review. Results: ACV can be used as an option in adjuvant therapy for antibiotics in overcoming the problem of antibiotic resistance. ACV works by inhibiting the growth of bacteria, which can be done by eliminating the expression of several proteins and enzymes that are crucial in bacterial growth. ACV can also reduce pro-inflammatory cytokines, increase monocyte activity, and fight free radicals. In the meantime, ACV is easy to obtain at an affordable price. However, the lack of studies on the effects of ACV is still an obstacle to potentiating this adjuvant therapy. Conclusions: ACV can be used as adjuvant therapy in overcoming the problem of antibiotic resistance. Further research is still needed to determine the exact mechanism and effectiveness of ACV in the problem of antibiotic resistance. Keywords: antibiotic resistance, apple cider vinegar, antimicrobial.