Clove, guava leaves can enhance effectiveness of antibiotics to treat typhoid

Currently, the development of new antibiotics is decreasing, while the emergence of resistant bacteria due to factors such as mutation, inappropriate use and diagnostics, and prescription of antibiotics for persistent patients are gradually limiting the use of some early commonly prescribed antibiotics in the treatment of infections and diseases.

It is imperative, therefore, to keep looking for new drug combinations, including compounds from nature that can enhance or maintain efficacy, while minimising toxicity and delaying the development of drug resistance.

Typhoidal and non-typhoidal Salmonella infection is of growing concern in developing countries and new approaches are required for the treatment of infections caused by these germs which have become resistant to available and commonly prescribed antibiotics.

Salmonella infections cause millions of infections, hospitalisation, and deaths every year worldwide. In fact, Salmonella typhi was shown to be resistant to commonly prescribed antibiotics in some parts of Nigeria, Pakistan and Ethopia.

With the decline in development of new antibiotics, scientists keep trying to develop or propose some synergistic combinations of antibiotics with medicinal plant extracts in an effort to boost their antimicrobial activities against drug-resistant germs.

For Salmonella typhi shown to be resistant to commonly prescribed antibiotics, researchers developed a cocktail regimen, which is highly susceptible to drug resistant clinical isolate of Salmonella using Tetracycline, Co-trimoxazole, Aspirin, guava leaves and cloves.

The researchers had set out to develop a method for which the antimicrobial activity of in-effective commonly prescribed antibiotics for the treatment of Salmonella species can be enhanced at lower concentration and also to induce antimicrobial activity on a non-antimicrobial drug.

It was in the 2023 edition of the journal, Fine Chemical Engineering.

Twenty-four different combinations of three drugs (Co-trimoxazole, Tetracycline and Aspirin) each with clove extract and separately again with guava extract were subjected to test to ascertain if they can be used to combat multidrug-resistant bacteria and other disease-causing organisms.

The antimicrobial susceptibility test revealed that a combination of Co-trimoxaazole with clove extract, a combination of Aspirin and clove extract and a combination of Aspirin and guava leave extracts were all susceptible to the confirmed resistant isolate of Salmonella germ.

The combination of Aspirin and clove extract had the best zone of inhibition, better than Ciprofloxacin, a broad-spectrum antibiotic.

The researchers declared that aspirin was the best precursor drug, which favourably combines with both clove and guava extract to give a desired cocktail regimen with potential antimicrobial characteristics, hence the need to identify the chemical constituents in these combinations for further test.

“This is to ascertain if they can be used to combat multidrug resistant bacteria and other disease-causing germs,” they said.

Guava and cloves are important medicinal plant used in the treatment of diarrhoea, stomach ache, diabetes, bronchitis, asthma attacks, sexually transmitted infections and for the treatment of dysentery.

Studies also say that water extracts of clove and ethanolic extracts of guava were effective against different forms of Salmonella, the germ that causes typhoid.

Tetracycline and Co-trimoxazole are both broad spectrum antibiotics and effective in the treatment of many infections, while aspirin belongs to the groups of medications that is used to relieve pain, fever, and inflammation in various conditions, such as lower back and neck pain, flu, common cold, headache, rheumatoid arthritis, as well as sprains and strains.

Numerous studies have confirmed synergistic effects of plant extracts and antibiotics, with a possible reduction the effective dose of antibiotics on one side and the side effects of antibiotics as medicine.

The alarming growth of the number of antibiotic resistant bacteria and difficulties in treatment of infections have initiated a search for new antibacterial compounds and developed new alternative strategies for combating bacterial infections.

Scientists have tested various types of extracts from numerous plants in combination with different antibiotics. The ethanol extract of Pomegranate rind showed very good synergistic activity with ciprofloxacin, resulting in a significant improvement in its effectiveness against Klebsiella pneumoniae resistant strain, which can lead to a range of illnesses, including pneumonia, bloodstream infections, meningitis, and urinary tract infections.

Also, is the antibacterial and modulatory potential of the extract from the leaves and barks of the neem tree in combination with drugs like gentamicin and penicillin (amoxicillin) against Staphylococcus aureus (causes infections such as boils and furuncles), Escherichia coli (causes diseases such as urinary tract infection, abdominal and pelvic infection, pneumonia and meningitis) and Pseudomonas aeruginosa (causes diseases such as pneumonia, urinary tract infections (UTIs), and infections in the blood). bacteremia.

Guava leaf also showed synergistic effect with antibiotics such as gentamicin and ciprofloxacin against E. coli, Pseudomonas aeruginosa and Staphylococcus. aureus.

In the case of Juglans regia (English walnut) extract, 10-fold increase was observed against S. aureus when it used in combination with oxacillin. In this combination, oxacillin was able to inhibit Methicillin-resistant Staphylococcus aureus (commonly known as MRSA) and one of the causes of bacterial infection of the skin.

Still, the combinations of propolis and ginger with clarithromycin intensified controlling of Helicobacter pylori, the germ that causes stomach ulcer. There is also a synergism of bitter kola nuts extract with amoxicillin, ciprofloxacin, tetracycline and chloramphenicol.