Potentiation of the in vitro Antistaphylococcal Effect of Oxacillin and Tetracycline by the Anti-Inflammatory Drug Diacetyl Rhein

Abstract

Background: The anti-inflammatory drug diacetyl rhein has been found to possess promising antistaphylococcal effects against various drug-resistant strains in our previous study. In the present work, we explored the in vitro combinatory interactions of diacetyl rhein with oxacillin and tetracycline against 13 standard strains and clinical isolates of Staphylococcus aureus, including those resistant to erythromycin, methicillin and tetracycline. Methods: Minimum inhibitory concentrations were determined by broth microdilution assay, and the effects of combinations were evaluated according to the sum of fractional inhibitory concentrations (ΣFICs). Results: Synergistic or additive effects were observed against all S. aureus strains (ΣFIC 0.258-1), whereas diacetyl rhein-oxacillin appeared to be the most effective combination, synergistically inhibiting the growth of 4 strains tested. Conclusion: To our best knowledge, this is the first report on a synergistic antibacterial effect of diacetyl rhein. Our results suggest this promising compound for further evaluation of its synergistic anti-infective potential as an agent with a combined anti-inflammatory and synergistic antibacterial action.

Determination of anti-staphylococcal activity of thymoquinone in combinations with antibiotics by checkerboard method using EVA capmat™ as a vapor barrier

“…as laxative (Bruneton, 1999) and antiinflammatory agents (Nguon et al, 2014). In addition, our previous study demonstrated that redox potential alone could not fully explain all aspects of pharmacological action of quinones (Landa et al, 2012).…”

In Vitro Antimicrobial Activity of Diacerein on 76 Isolates of Gram-Positive Cocci from Bacterial Keratitis Patients and In Vivo Study of Diacerein Eye Drops on Staphylococcus aureus Keratitis in Mice

“…Despite a previous in vitro study describing promising growth-inhibitory effects of diacerein against various drug-resistant staphylococcal strains (19), the synergistic anti-Staphylococcus aureus effects of its active metabolite rhein with ampicillin and oxacillin were also discovered (20). No data have reported the results of the use diacerein against Gram-positive bacteria in ophthalmology or against strains such as Enterococcus spp., Staphylococcus intermedius, Staphylococcus haemolyticus, Staphylococcus xylosus, Staphylococcus hominis, and Staphylococcus capitis.…”

“…It works by blocking the actions of interleukin-1 beta, a protein involved in inflammation. A previous in vitro study showed that diacerein has growth-inhibitory effects against various drug-resistant staphylococcal strains, and synergistic or additive effects with oxacillin and tetracycline were observed against all Staphylococcus aureus strains (19,20). To date, there are no reports describing the therapeutic effect of diacerein for the treatment of bacterial keratitis.…”

In vitro antimicrobial mechanism of diacerein and potential to reverse MRSE resistance to β-lactams

“…Combined drug sensitivity results. Prior research has suggested that diacerein can enhance the antibacterial effect of oxacillin on Staphylococcus aureus in vitro [15] . In this study, the combined drug sensitivity test of four β-lactam drugs and diacerein was carried out for MRSE, and FIC values was shown in Table 3.…”