Botanicals for Adjunct Therapy and the Treatment of Multidrug-Resistant Staphylococcal Infections

Abstract High prevalence of multidrug-resistant microorganisms in the etiologic structure of different infectious processes significantly decreases the effectiveness of the treatment and enhances the probability of an unfavorable outcome from the infection. Combinations between antibiotics and other antimicrobial agents represent one of the most promising approaches for combating multidrug-resistant bacteria. A high therapeutic potential exists for combinations of antibiotics and natural antimicrobial substances with complex mechanisms of action and multiple healing properties, such as plant essential oils. The purpose of the present chapter is to review published studies on antibiotic-essential oil combinations and discuss the prospects for future studies. In general, many studies have shown the potential for essential oils to act synergistically with antibiotics in vitro . The main proposed mechanism of this beneficial effect is through inhibition of efflux pumps by some essential oils, which restores the activity of the antibiotic. Future efforts should be directed into further studies of antibiotic-essential oil combinations against multidrug-resistant bacteria, with an emphasis on understanding the mechanisms of the produced effect. Combinations of essential oils with different types of antimicrobial agents, such as bacteriophages, nanoparticles, and quorum-sensing inhibitors, require greater attention and are worthy of future investigations.