The Effect of Chamomile Tonic on the Antimicrobial Activity of Antibiotics Used in Acne Treatment

Abstract

Acne vulgaris is one of the most common dermatological diseases affecting adolescents, and when not treated appropriately, it may lead to permanent skin lesions and significant psychosocial consequences. In recent years, alongside topical and systemic agents, interest in herbal alternatives has been steadily increasing in treatment approaches. It is currently suggested that, rather than synthesizing new antimicrobial compounds, the most realistic strategy for the management of resistant bacterial infections is the inhibition of resistance mechanisms. In this study, it was aimed to determine the effects of two different tonics prepared with two different chamomile waters on the minimum inhibitory concentrations (MICs) of azithromycin, clarithromycin, and clindamycin against clinical isolates of Staphylococcus aureus and Staphylococcus epidermidis, as well as to calculate the ideal inhibitory concentrations capable of reversing resistance to these antibiotics. Antibiotic susceptibility testing was re-evaluated in the presence of the chamomile water–based tonic for S. aureus and S. epidermidis isolates obtained from the Department and identified as resistant to azithromycin, clarithromycin, and clindamycin. Antimicrobial susceptibility profiles were determined using the broth microdilution method, and the checkerboard method was applied to isolates showing decreased MIC values in the presence of the chamomile water tonic. Inhibitory concentrations capable of reversing antibiotic resistance and fractional inhibitory concentration (FIC) indices were calculated, and the effects of the combinations were defined as additive. Most of the newly obtained MIC values were found to be within the EUCAST susceptibility breakpoints. In conclusion, antibiotic concentrations remaining below resistance thresholds through appropriate combinations may represent a rational treatment approach with the potential to restore antibiotic efficacy.

Keywords

• Acne vulgaris
• chamomile water
• antibiotic resistance
• Staphylococcus aureus
• Staphylococcus epidermidis

Papatya suyu toniğinin akne tedavisinde kullanılan antibiyotiklerin etkinliği üzerine etkisi

Abstract

Akne vulgaris, genç bireyleri en sık etkileyen dermatolojik hastalıklardan biridir. Uygun tedavi edilmediğinde kalıcı cilt lezyonlarına ve psikososyal etkilere yol açabilir. Günümüzde tedavi yaklaşımlarında topikal ve sistemik ajanların yanı sıra bitkisel alternatiflere olan ilgi giderek artmaktadır. Son yıllarda, dirençli bakteri enfeksiyonlarının tedavisinde en gerçekçi yaklaşımın, yeni antimikrobiyal bileşiklerin sentezlenmesinden çok, direnç mekanizmalarının inhibisyonu olduğu düşünülmektedir. Çalışmamızda, iki farklı papatya suyu ile hazırlanan iki farklı toniğin S. aureus ve S. epidermidis klinik izolatlarında, azitromisinin, klaritromisinin ve klindamisinin minimum inhibitör konsantrasyonu (MİK) üzerine etkisinin saptanması, azitromisin, klindamisin ve klaritromisin direncini ortadan kaldıran ideal inhibitör konsantrasyonunun hesaplanması amaçlanmıştır. Çalışmamızda kullanılmak üzere Anabilim Dalı’ndan temin edilen Staphylococcus aureus ve Staphylococcus epidermidis izolatlarının azitromisin, klindamisin ve klaritromisine dirençli olduğu tespit edilenlerin antibiyotik duyarlılığı papatya suyu ile hazırlanan toniğin varlığında yeniden araştırılmıştır. Antimikrobiyal duyarlılık profilinin belirlenmesinde broth mikrodilüsyon yöntemi kullanılmıştır. Papatya suyu toniğinin varlığında MİK değerlerinde azalma gözlenen izolatlar için dama tahtası yöntemi uygulanmıştır. Antibiyotiklerin direncini ortadan kaldıran inhibitör konsantrasyonları ile fraksiyonel inhibitör konsantrasyon (FİK) indeksleri hesaplanmış ve . kombinasyonların etkisi aditif olarak tanımlanmıştır. Elde edilen yeni MİK değerlerinin çoğunun EUCAST duyarlılık sınırları içerisinde kaldığı belirlenmiştir. Sonuç olarak, uygun kombinasyonlar ile direnç sınırlarının altında kalan antibiyotik konsantrasyonları, antibiyotik etkinliğini yeniden kazanma potansiyeli taşıyan rasyonel bir tedavi yaklaşımı olabilir.

Keywords

• Akne vulgaris
• papatya suyu
• antibiyotik direnci
• Staphylococcus aureus
• Staphylococcus epidermidis

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