Counteracting methicillin resistant Staphylococcus aureus through novel Citral-Azithromycin combination

Abstract Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant challenge, necessitating novel therapeutic strategies. This study demonstrates the synergistic bactericidal activity of citral, a phytochemical, and azithromycin against clinical MRSA isolates. Checkerboard assays confir...

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Main Authors: Hitesh K. Sharma, Ibha Singh, Amarnath Karna, Puneet Gupta, Taru Singh, Anoop Kumar, Deepti Pandita, Monalisa Mukherjee, Virinder S. Parmar, Pallavi Agarwal, Viney Lather
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-025-11721-4
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author Hitesh K. Sharma
Ibha Singh
Amarnath Karna
Puneet Gupta
Taru Singh
Anoop Kumar
Deepti Pandita
Monalisa Mukherjee
Virinder S. Parmar
Pallavi Agarwal
Viney Lather
author_facet Hitesh K. Sharma
Ibha Singh
Amarnath Karna
Puneet Gupta
Taru Singh
Anoop Kumar
Deepti Pandita
Monalisa Mukherjee
Virinder S. Parmar
Pallavi Agarwal
Viney Lather
author_sort Hitesh K. Sharma
collection DOAJ
description Abstract Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant challenge, necessitating novel therapeutic strategies. This study demonstrates the synergistic bactericidal activity of citral, a phytochemical, and azithromycin against clinical MRSA isolates. Checkerboard assays confirmed synergy with a fractional inhibitory concentration index (FICI) of 0.093, while time-kill kinetics showed a reduction in bacterial viability from 5.39 to 2.94 log10 CFU/ml, outperforming monotherapy. Scanning electron microscopy revealed severe cellular damage, indicative of membrane disruption and protein leakage. Notably, the combination extended post-antibiotic effects (PAE) by 4.26 h at MIC, suggesting prolonged antibacterial action. Cytotoxicity assays on normal human fibroblasts demonstrated 93.7% viability at the combined MIC, underscoring its biocompatibility. These findings highlight citral-azithromycin synergy as a promising strategy to enhance antibiotic efficacy against MRSA while minimizing cytotoxicity, supporting the potential of phytochemical-adjuvant combinations in combating antimicrobial resistance.
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issn 2045-2322
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series Scientific Reports
spelling doaj-art-d6fab381ecb543aea6d3b9fc1c3d79dc2025-08-20T03:43:26ZengNature PortfolioScientific Reports2045-23222025-07-0115111310.1038/s41598-025-11721-4Counteracting methicillin resistant Staphylococcus aureus through novel Citral-Azithromycin combinationHitesh K. Sharma0Ibha Singh1Amarnath Karna2Puneet Gupta3Taru Singh4Anoop Kumar5Deepti Pandita6Monalisa Mukherjee7Virinder S. Parmar8Pallavi Agarwal9Viney Lather10Amity Institute of Pharmacy, Amity University Uttar PradeshAmity Institute of Molecular Medicine and Stem Cell Research, Amity UniversityAmity Institute of Molecular Medicine and Stem Cell Research, Amity UniversityAmity Institute of Pharmacy, Amity University Uttar PradeshAmity Institute of Biotechnology, Amity UniversityDepartment of Pharmacology, Delhi Pharmacological Sciences and Research University (DPSRU)Department of Pharmaceutics, Delhi Institute of Pharmaceutical Sciences & Research (DIPSAR) Delhi Pharmaceutical Sciences and Research UniversityAmity Institute of Click Chemistry and Research Studies, Amity University Uttar PradeshAmity Institute of Click Chemistry and Research Studies, Amity University Uttar PradeshAmity Institute of Molecular Medicine and Stem Cell Research, Amity UniversityAmity Institute of Pharmacy, Amity University Uttar PradeshAbstract Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant challenge, necessitating novel therapeutic strategies. This study demonstrates the synergistic bactericidal activity of citral, a phytochemical, and azithromycin against clinical MRSA isolates. Checkerboard assays confirmed synergy with a fractional inhibitory concentration index (FICI) of 0.093, while time-kill kinetics showed a reduction in bacterial viability from 5.39 to 2.94 log10 CFU/ml, outperforming monotherapy. Scanning electron microscopy revealed severe cellular damage, indicative of membrane disruption and protein leakage. Notably, the combination extended post-antibiotic effects (PAE) by 4.26 h at MIC, suggesting prolonged antibacterial action. Cytotoxicity assays on normal human fibroblasts demonstrated 93.7% viability at the combined MIC, underscoring its biocompatibility. These findings highlight citral-azithromycin synergy as a promising strategy to enhance antibiotic efficacy against MRSA while minimizing cytotoxicity, supporting the potential of phytochemical-adjuvant combinations in combating antimicrobial resistance.https://doi.org/10.1038/s41598-025-11721-4
spellingShingle Hitesh K. Sharma
Ibha Singh
Amarnath Karna
Puneet Gupta
Taru Singh
Anoop Kumar
Deepti Pandita
Monalisa Mukherjee
Virinder S. Parmar
Pallavi Agarwal
Viney Lather
Counteracting methicillin resistant Staphylococcus aureus through novel Citral-Azithromycin combination
Scientific Reports
title Counteracting methicillin resistant Staphylococcus aureus through novel Citral-Azithromycin combination
title_full Counteracting methicillin resistant Staphylococcus aureus through novel Citral-Azithromycin combination
title_fullStr Counteracting methicillin resistant Staphylococcus aureus through novel Citral-Azithromycin combination
title_full_unstemmed Counteracting methicillin resistant Staphylococcus aureus through novel Citral-Azithromycin combination
title_short Counteracting methicillin resistant Staphylococcus aureus through novel Citral-Azithromycin combination
title_sort counteracting methicillin resistant staphylococcus aureus through novel citral azithromycin combination
url https://doi.org/10.1038/s41598-025-11721-4
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