Plant Phyto-constituents as Antibiotic Adjuvants: A Systematic Review and Bibliometric Analysis

Abstract

The advent of antibiotics in the 19th century has significantly reduced the morbidity and mortality of infectious diseases. However, irrational use of antibiotics in humans as well as in animals has driven the 21st century to the rapid emergence of MultiDrug Resistance Bacteria (MRB). Moreover, the dissemination of COVID-19 pandemic has paved the way for MRB, typically due to increased use of antibiotics to avoid secondary infections. The fast pace progression of bacterial resistance for the antibiotics and their combinations is making the management of MRB infections tough and increasing the cost of the treatment as well. However, use of Efflux Pump Inhibitors (EPI) as adjuvant for antibiotics has shown a ray of hope by retaining the susceptibility of the antibiotics and thereby reducing the burden of immediate requirement of new antibiotics for MRB. Accordingly, the present paper is aimed to scrutinize the predominant literature depicting the plant Phyto-constituents as an EPI and adjuvant for antibiotics in the management of MRB infections. The systematic review of the present paper indicates that the plant phyto-constituents belonging to the class of alkaloids, terpenoids, flavonoids can effectively be used as EPIs for antibiotics such as Ciprofloxacin, Norfloxacin, Tetracyclines and Chloramphenicol. Bibliometric analysis indicates that the Journal of Antimicrobial Chemotherapy, Antimicrobial Agents and Chemotherapy and BMC Complementary & Alternative Medicine have published impactful articles on EPI potential of plant phyto-constituents. Further, authors Kuete V, Dzotam JK, Falcao-silva VD, Gibbons S, Kuiate JR, Mbaveng AT, Tankeo SB and  Voukeng IK are the major contributors and productive authors.