Synergistic potentiation of antibiotics by chamomile phytochemicals against multidrug-resistant Helicobacter pylori
Abstract
BACKGROUND: Helicobacter pylori is a significant global health issue, infecting nearly half of the population. Increasing antibiotic resistance leads to treatment failures. This study examined the antibacterial effects of chamomile ethanolic extract, both alone and combined with standard antibiotics, as a potential approach to fighting antibiotic-resistant H. pylori strains. METHODS: Thirty antral gastric biopsies were collected from patients undergoing diagnostic upper endoscopy at El-Demerdash Hospital in Cairo, Egypt. H. pylori isolates were identified by rapid urease test (RUT), cultured, and tested for antimicrobial susceptibility to clarithromycin (CLR, 15 µg), metronidazole (MET, 5 µg), amoxicillin (AX, 25 µg), tetracycline (TE, 30 µg), rifampicin (RA, 30 µg), and levofloxacin (LEV, 5 µg). The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined. The antibacterial activity of chamomile ethanolic extract was tested alone and in combination with these antibiotics. Phytochemical profiling was conducted using FT-IR and GC-MS. The identified compounds were analyzed through molecular docking against ten H. pylori targets: lipoprotein 20 (LPP20, HP1456), aspartate α-decarboxylase (ADC), S-ribosylhomocysteinase (LuxS), GTP cyclohydrolase II (GCH II), cytotoxin-associated gene A (CagA), sialic acid-binding adhesin (SabA), blood group antigen-binding adhesin (BabA), vacuolating cytotoxin A (VacA), and fructose-1,6-bisphosphate…
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