Natural Extracts as a Promising Solution for Gram-Positive Antibiotic Resistance: A Comprehensive Review

Abstract

Background: Antibiotic resistance is currently one of the biggest problems in public health. Infectious diseases are the second human death cause, and the emergence of antimicrobial-resistant bacteria increases mortality and morbidity rates. There is a growing clinical need for the development of new antibiotics. In this line, WHO issued an alert about 12 bacteria with an urgent need to develop new antibiotics. Aims: This review aims to analyze the current knowledge of their antibacterial activity against the gram-positive pathogens listed by WHO and their extraction techniques. Methods: We systematically reviewed the literature in PubMed, searching publications describing the use of natural extracts as antibiotics over bacteria. The exclusion criteria consisted of limiting papers on natural extracts tested over the bacteria culture related to eleven selected bacteria, according to an alert issued by WHO in 2017, and seven plant extracts. Results: All the gram-positive bacteria present in the WHO alert have been treated, with different degrees of advance, with some of the plant extracts and plant-based compounds reviewed. Currently, they are in the preclinical stage. Edible herbs are more often used, as well as artemisia and wine byproducts. Discussion: Natural products based on plants have shown to be efficient in inhibiting bacterial growth, even in antibiotic-resistant strains. The classical extraction methods are still in use and have been improved with the available technology to improve efficiency and yield. Conclusions: Ongoing evidence shows that plant extracts and plant-based compounds are effective as antibacterial, with minimal effects on the host cell, a promising antibiotic source. Furthermore, they are sustainable, environmentally friendly, and renewable.