{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T11:23:56Z","timestamp":1787916236479,"version":"build-2784847793"},"reference-count":147,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Planta Med"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The purpose of this review is to summarize the current knowledge acquired on herbal products and their active constituents with antimicrobial activity used alone and in combination with\n\t\t\t\t\tantibiotics against multidrug-resistant bacteria. The most promising herbal products and active constituents used alone against multidrug-resistant bacteria are Piper betle\n\t\t\t\t\t(methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, extended-spectrum beta-lactamase, Acinetobacter baumannii, Pseudomonas aeruginosa),\n\t\t\t\t\t\tGlycyrrhiza glabra (methicillin-resistant S. aureus, vancomycin-resistant Enterococcus, P. aeruginosa), and berberine (methicillin-resistant S. aureus,\n\t\t\t\t\t\tA.\u00a0baumannii, P. aeruginosa), respectively. The synergistic effect of the combination of herbal products and their active constituents with antibiotics against multidrug-resistant\n\t\t\t\t\tbacteria are also described. These natural antibacterial agents can be promising sources of inhibitors, which can modulate antibiotic activity against multidrug-resistant bacteria,\n\t\t\t\t\tespecially as efflux pump inhibitors. Other possible mechanisms of action of herbal therapy against multidrug-resistant bacteria including modification of the bacterial cell wall and\/or\n\t\t\t\t\tmembrane, inhibition of the cell division protein filamenting temperature sensitive Z-ring, and inhibition of protein synthesis and gene expression, all of which will also be discussed. Our\n\t\t\t\t\treview suggests that combination herbal therapy and antibiotics can be effectively used to expand the spectrum of their antimicrobial action. Therefore, combination therapy against\n\t\t\t\t\tmultidrug-resistant bacteria may enable new choices for the treatment of infectious diseases and represents a potential area for future research.<\/jats:p>","DOI":"10.1055\/a-1890-5559","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T23:00:09Z","timestamp":1661209209000},"page":"168-182","source":"Crossref","is-referenced-by-count":24,"title":["Herbal Products and Their Active Constituents Used Alone and in Combination with Antibiotics against Multidrug-Resistant Bacteria"],"prefix":"10.1055","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2722-6195","authenticated-orcid":false,"given":"Anna","family":"Herman","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Warsaw School of Engineering and Health, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej P.","family":"Herman","sequence":"additional","affiliation":[{"name":"Department of Genetic Engineering, The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, Jab\u0142onna near Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,8,22]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1007\/s13205-017-0848-9","article-title":"Plant-derived antimicrobials to fight against multi-drug-resistant human pathogens","volume":"7","author":"R Subramani","year":"2017","journal-title":"3 Biotech"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.idc.2016.02.004","article-title":"Multidrug-resistant bacteria in the community: Trends and lessons learned","volume":"30","author":"D van Duin","year":"2016","journal-title":"Infect Dis Clin North Am"},{"key":"ref3","first-page":"1179","article-title":"Plant natural products: 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