Effect of 3,3'-Diindolylmethane on the Antibacterial Activity of Fluoroquinolones as Constituents of Potential Drug Products for Topical Application
Abstract
The aim of the study was to overcome the resistance to fluoroquinolones of Gram-positive and Gram-negative, largely drug-resistant bacteria that infect combat-related traumatic injuries to the skin and adjacent tissues. For this purpose, 0.1% ofloxacin, levofloxacin, or moxifloxacin in combination with 0.1%, 0.5%, or 1.0% of 3,3'-diindolylmethane (DIM) were incorporated into a water-soluble ointment base. The experimental results showed that the ointment base promoted the release of ofloxacin while it absorbed a significant amount of water. In vitro experiments using the agar diffusion method demonstrated that the components of the ointment base and DIM in increasing concentrations enhanced the susceptibility of 6 clinical bacterial strains to fluoroquinolones. A colloidal nonionic surfactant solution containing 0.1% ofloxacin and 1.0% DIM effectively prevented biofilm formation of both clinical strains and a standard strain of Pseudomonas aeruginosa. Confocal laser scanning microscopy revealed that the impact of the colloidal solution on biofilm formation by P. aeruginosa 4791 resulted in a remarkable destruction of the biofilm integrity, accompanied by a significant reduction in biofilm thickness. This research highlights the potential of the combined use of fluoroquinolones and DIM in water-soluble ointments for the local treatment of purulent wounds infected with resistant bacterial strains in the inflammatory phase.
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