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SUBMITTED BY- UNDER GUIDANCE OF-SUVID FADANVIS DR. V. N. CHARDE

´To study the combined

effect of Ayurvediccompounds and antibiotics

against drug resistant

Bacteriaµ



Antibiotics:Antimicrobial compound derived from

microbial origin

Inhibits vital processes of bacterial cells ormetabolism

five major classes:1. Cell wall inhibitors2. Inhibitors of nucleic acid synthesis3. Protein synthesis inhibitors4. Anti-metabolites5. Antibiotics that can damage the cellmembrane



Antibiotic Resistance �Genetic drug resistance -

Reduced permeability or uptake. Enhanced efflux. Enzymatic inactivation. Alteration of the drug target.

�Phenotypic drug

resistance- Biofilm formationSalicylate inducedresistanceBacterial persisters

Managing problem of drug resistance

Prevent spread of drug resistant bacteriaDevelopment of new antibioticsPhage therapyHost defense mechanismsUse of normal microbial flora



AN AYURVEDIC APPROACH TO MICROBIAL INFECTIONS

Western approach- Microbial infection is primary cause ofinfectious diseases.Ayurveda recognizes the microbial approach, but not as theprimary cause of disease.

According to the Ayurvedic approach- anyone who hasdeveloped an imbalance in physiological,metabolical, and

biochemical constituent of body and therefore weakened theirimmune system, may be subject to a microbial infection.



Class Example MechanismSimple phenols andphenolic acids.

Catechol,Cinnamic acid,

caffeic acid, pyrogallol

enzyme inhibition by the

oxidized compoundsQuinones Hypericin Bind to adhesins, complex

with cell wall, inactivateenzymes

Tannins Ellagitannin Bind to proteins, Enzyme

inhibition, Complex with cell

wall, Membrane disruptionTerpenoids and EssentialOil

Camphor,Capsaicin Membrane disruption

Alkaloids Berberine Intercalate into cell walland/or DNA

Lectins and Polypeptides Thionines, Fabatins formation of ion channelsin the microbial membraneor competitive inhibition ofadhesion of microbialproteins to hostpolysaccharide receptors.

Major classes of antimicrobial compounds in Ayurvedic medicines



Objective To evaluate combined effect of differentAyurvedic preparations and antibioticsagainst drug resistant bacteria.

Ayurvedic MedicinesKatujarishtaDasamoolarishtaTribhuvan kirti ras

TriphalaDrakshasava

Bacterial culturesresistant to

antibiotics- Ampicillin,Ciprofloxacin

E. coli- isolated from stoolof patient

P. aeroginosa- isolated fromblood

K . pneumoniae- isolatedfrom pus

S. aureus- isolated from



M

ethodologySterilizationConfirmed resistance of bacterial culture to antibioticsAmpicillin and Ciprofloxacin by Agar well diffusion method.Maintenance of organism on Nutrient Agar slantInoculum preparation in Nutrient BrothAntimicrobial sensitivity test by Agar well diffusionmethod



Result & Discussion



Ampicillin Ciprofloxacin Katujarishta Katujarishta + Ampicillin Katujarishta + Ciprofloxacin

0 0

7

26

34

0 0

28

17

34

0 0

19

14 14

0 0

28

38

43

Activity of Katujarishta withAntibiotics against clinical isolates of drug resistant bacteria

E. coli P.aerginosa K.pneumoniae S. aureus

Bacterial

Culture

Zone of inhibition in mm

Ampicillin Ciprofloxacin Katujarishta Katujarishta +

AmpicillinKatujarishta +Ciprofloxacin

E. coli - - 7 26 34

P.aerginosa - - 28 17 34

K.pneumoniae - - 19 14 14

S. aureus - - 28 38 43



Ampicillin Ciprofloxacin Dasamool-arishta Dasamool-arishta +

Ampicillin

Dasamool-arishta +

Ciprofloxacin

0 0

9

24

37

0 0

2321

31

0 0

2624

28

0 0

24

14

28

Activity of Dasamoolarishta withAntibiotics against clinical isolates of drug resistant bacteria


Bacterial

Culture


Ampicillin Ciprofloxacin Dasamool-

arishta

Dasamool-

arishta +

Ampicillin

Dasamool-

arishta +

Ciprofloxacin

E. coli - - 9 24 37

. er i os - - 23 2 3

K.p eumo i e - - 26 24 28

S. ureus - - 24 4 28



Ampicillin Ciprofloxacin Tribhuvan Kirti ras Tribhuvan Kirti ras +

Ampicillin

Tribhuvan Kirti ras +

Ciprofloxacin

0 0

17

30

40

0 0

26

0

32

0 0

2628 28

0 0 0 0

21

Activity of Tribhuvan kirti ras withAntibiotics against clinical isolates of druresistant bacteria


Bacterial

Culture


Ampicillin Ciprofloxacin Tribhuvan

Kirti ras

Tribhuvan

Kirti ras +Ampicillin

Tribhuvan

Kirti ras +Ciprofloxacin

E. coli - - 17 30 40

P.aerginosa - - 26 - 32

. ne oniae - - 26 2 2

S. a re s - - - - 21



Ampicillin Ciprofloxacin Triphala Triphala + Ampicillin Triphala + Ciprofloxacin

0 0

21 21

24

0 0

10

12

26

0 0

8

14

29

0 0

10

18

29

Activity of Triphala withAntibiotics against clinical isolates of drug resistantbacteria


Bacterial

Culture


Ampicillin Ciprofloxacin Triphala Triphala +Ampicillin

Triphala +Ciprofloxacin

E. coli - - 21 21 24


K.pneumoniae - - 8 14 29

S. aureus - - 10 18 29



Ampicillin Ciprofloxacin Drakshasava Drakshasava + Ampicillin Drakshasava + Ciprofloxacin

0 0 0

29

35

0 0

9

1718

0 0 0

18

34

0 0 0

11

27

Activity of Drakshasava withAntibiotics against clinical isolates of drug resistant bacteria


Bacterial

Culture


Ampicillin Ciprofloxacin Drakshasava Drakshasava +Ampicillin

Drakshasava +Ciprofloxacin

E. coli - - - 29 35


K.pneumoniae - - - 18 34

S. aureus - - - 11 27



ConclusionObjective of this work was to study combined effect of

Ayurvedic medicines and Antibiotics against drug resistantbacteria.We take clinical isolates of 4 organisms resistant to someantibiotics, generally used to treat disease caused by theseorganisms.

In most cases organisms resistant to antibiotics become

sensitivity when combined with some ayurvedic medicines. Incertain cases organisms were sensitive ayurvedic medicines, butsensitivity increases when combined with antibiotics.

It was interesting to know that, in some cases although

organisms were resistant to both antibiotics and ayurvedicmedicines but sensitive to their combination.Thus- combination of 2 antimicrobial substrates can be an

effective approach to combat with problem of Antibioticresistance.



I would like to end with a quote by the Nobel Prizelaureate Joshua Lederberg:

Antibiotic resistance is neither a surprising

nor a new phenomenon. However it is anincreasingly worrisome situation, becauseresistance is growing and accelerating while theworld's tools for combating it decrease in power and number

We must remember that the microbes have been

on this planet much longer than we have and candevelop resistance to any antibiotics used to treat them.We should use a combination of approaches asdiscussed above to minimize the resistance problem.,

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