IArtemisia brevifolia/I Wall. Ex DC Enhances Cefixime Susceptibility by Reforming Antimicrobial Resistance

• Published in: Antibiotics (Basel) 2023-10, Vol.12 (10)
• Main Authors: Zafar, Aroosa, Wasti, Yusra, Majid, Muhammad, Muntaqua, Durdana, Bungau, Simona Gabriela, Haq, Ihsan ul
• Format: Article
• Language: English
• Subjects: Bioflavonoids; Cefixime; Esters; Flavones; Flavonoids; Metabolites; Polyphenols
• ISSN: 2079-6382; 2079-6382
• DOI: 10.3390/antibiotics12101553

(1) Background: A possible solution to antimicrobial resistance (AMR) is synergism with plants like Artemisia brevifolia Wall. ex DC. (2) Methods: Phytochemical quantification of extracts (n-hexane (NH), ethyl acetate (EA), methanol (M), and aqueous (Aq)) was performed using RP-HPLC and chromogenic assays. Extracts were screened against resistant clinical isolates via disc diffusion, broth dilution, the checkerboard method, time–kill, and protein quantification assays. (3) Results: M extract had the maximum phenolic (15.98 ± 0.1 μg GAE/mgE) and flavonoid contents (9.93 ± 0.5 μg QE/mgE). RP-HPLC displayed the maximum polyphenols in the M extract. Secondary metabolite determination showed M extract to have the highest glycosides, alkaloids, and tannins. Preliminary resistance profiling indicated that selected isolates were resistant to cefixime (MIC 20–40 µg/mL). Extracts showed moderate antibacterial activity (MIC 60–100 µg/mL). The checkerboard method revealed a total synergy between EA extract and cefixime with 10-fold reductions in cefixime dose against resistant P. aeruginosa and MRSA. Moreover, A. brevifolia extracts potentiated the antibacterial effect of cefixime after 6 and 9 h. The synergistic combination was non- to slightly hemolytic and could inhibit bacterial protein in addition to cefixime disrupting the cell wall, thus making it difficult for bacteria to survive. (4) Conclusion: A. brevifolia in combination with cefixime has the potential to inhibit AMR.