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The identification of natural antibacterial phytochemicals has renewed interest due to the current scarcity of antibiotic development. Carvacrol is a monoterpenoid found in herbs. We evaluated carvacrol alone and combined with selected\u00a0antibiotics against four strains of\n                    <jats:italic>S. pyogenes<\/jats:italic>\n                    in vitro. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of carvacrol against\n                    <jats:italic>S. pyogenes<\/jats:italic>\n                    were 125\u00a0\u00b5g\/mL (0.53\u00a0mM) and 250\u00a0\u00b5g\/mL (1.05\u00a0mM), respectively. Kill curve results showed that carvacrol exhibits instantaneous bactericidal activity against\n                    <jats:italic>S. pyogenes.<\/jats:italic>\n                    We also demonstrated the potential mechanism of action of carvacrol through compromising the cell membrane integrity. Carvacrol induced membrane integrity changes leading to leakage of cytoplasmic content such as lactate dehydrogenase enzymes and nucleic acids. We further confirmed dose-dependent rupturing of cells and cell deaths using transmission electron microscopy. The chequerboard assay results showed that carvacrol possesses an additive-synergistic effect with clindamycin or penicillin. Carvacrol alone, combined with clindamycin or penicillin, can be used as a safe and efficacious natural health\u00a0product for managing streptococcal pharyngitis.\n                  <\/jats:p>","DOI":"10.1038\/s41598-020-79713-0","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T06:03:35Z","timestamp":1610690615000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":127,"title":["Carvacrol exhibits rapid bactericidal activity against Streptococcus pyogenes through cell membrane damage"],"prefix":"10.1038","volume":"11","author":[{"given":"Niluni M.","family":"Wijesundara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song F.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenyu","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Davidson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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