Abstract | The persistent misuse of antibiotics has resulted in antibiotic resistance in multiple bacterial strains. As a result, according to the Center for Disease Control and Prevention, around 35,000 out of 2.8 million individuals die due to infections caused by the resistant strains. One of the ways in which resistance is acquired is through the overexpression of efflux pumps that expel antibiotics from the cell, making them promising drug targets as efflux inhibitors can be used to improve existing antibiotics through synergy. In addition to this, potential adjuvants—compounds that have minimal antimicrobial activity but preserve existing antibiotics and potentiate their action—such as plant-derived compounds like flavonoids and berberine are being studied. This research sought to study the effects of flavonoids as an adjuvant on Pseudomonas fluorescens and Staphylococcus epidermidis with both antibiotic and berberine as the combined synergy of all three products remains vastly understudied. Escherichia coli was used as a reference as it is well-studied. Calibration curves were obtained by plotting the turbidity of the culture against the bacterial concentration by diluting a saturated culture. The minimum inhibitory concentration of the antibiotic was then determined through microbroth dilutions. First commercially used antibiotics—Cefotaxmine (cephlasporin), ciprofloxacin (fluroroquinolone), gentamicin (aminoglycoside) and nitrofurantoin—were used before flavones and berberine were studied through a synergy checkerboard assay to determine whether the combination of both antimicrobials resulted in a greater potency.
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