Combination of emodin with antibiotics against methicillin-resistant Staphylococcus aureus isolated from clinical specimens

Abstract Emodin (3-methyl-1,6,8-trihydroxyanthraquinone), a natural anthraquinone compound, is an active compound derivative isolated from the rhizome of Rheum undulatum L, an herb widely used as a laxative in traditional Korean medicine. Emodin has been reported to have a variety of biological activities, such as anti-cancer, vasorelaxation, immunosuppressive, anti-inflammatory and wound healing properties. In this study, emodin was evaluated against 20 clinical isolates of MRSA, either alone or in combination with antibiotics. The emodin exhibited strong antibacterial activity against isolates MRSA with MICs/MBCs ranged between 64-256/64-512 μg/mL, for ampicillin 64-512/128-1024 μg/mL, and for oxacillin 8-64/16-64 μg/mL. The combination of emodin plus oxacillin or ampicillin was reduced by ≥4-fold against isolates MRSA tested, evidencing a synergistic effect as defined by a FICI of ≤ 0.5. Furthermore, a time-kill study evaluating the growth of the tested bacteria was completely attenuated after 2-6 h of treatment with the 1/2 MIC of emodin, regardless of whether it was administered alone or with oxacillin (1/2 MIC) or ampicillin (1/2 MIC). In conclusion, emodin exerted synergistic effects when administered with oxacillin or ampicillin and the antibacterial activity and resistant regulation of emodin against clinical isolates of MRSA might be useful in controlling MRSA infections.

Keywords emodin, methicillin-resistant Staphylococcus aureus, minimum inhibitory concentrations, minimum bactericidal concentrations, time-kill curves, fractional inhibitory concentration.

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Combination of emodin with antibiotics against methicillin-resistant Staphylococcus aureus isolated from clinical specimens

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