Main Article Content
Abstract
Highlights:
1. Clove, cinnamon, and eucalyptus have found to be able to providing antibacterial agents for urinary tract infection (UTI).
2. Ethanol extracts derived from clove leaves, cinnamon bark, and eucalyptus leaves can inhibit pathogenic bacteria responsible for UTI, indicating their potential as sources of bioactive compounds for UTI medication development.
Abstract
Medicinal plants possess antimicrobial properties that have been believed to be efficacious for treating various diseases. However, antimicrobial-based medicinal plants remain an untapped source of potential pharmaceuticals. This study aimed to evaluate the antibacterial properties of ethanolic extracts derived from several medicinal plants endemic to Maluku, Indonesia, specifically regarding their antibacterial activity against isolates of pathogenic bacteria found in the urine samples of urinary tract infection (UTI) patients. This was a true experimental research with a posttest-only control group design. The medicinal plant extraction was conducted using the maceration method. The pathogens were isolated using the dilution method. Following the pathogen isolation, the isolates were identified according to the colony morphology, Gram staining, and biochemical test results. The antibacterial activity was determined through the Kirby-Bauer disc diffusion test. The results indicated that five selected isolates (i.e., 0A1, 0A2, 0A3, 0A4, and 0A5) had a round shape with flat edges. Isolates 0A2 and 0A4 exhibited a solid white color, whereas isolates 0A1 and 0A3 displayed an off-white color, and isolate 0A5 showed a yellow color. Isolates 0A1, 0A2, and 0A4 were Gram-positive bacteria, while isolates 0A3 and 0A5 demonstrated Gram-negative characteristics. The biochemical testing revealed that the five selected isolates were identified as Staphylococcus warneri, Staphylococcus haemolyticus, Enterobacter aerogenes, Enterococcus faecium, and Escherichia coli. The ethanol extracts of clove (Syzygium aromaticum) leaves, cinnamon (Cinnamomum burmannii) bark, and eucalyptus (Melaleuca leucadendra) leaves demonstrated the ability to inhibit pathogenic bacteria responsible for UTI. Clove leaf ethanol extract exhibited the highest average clear zone compared to the other two ethanol extracts. This study concluded that medicinal plants from Maluku, Indonesia, the clove, cinnamon, and eucalyptus, have antibacterial potential that may be effective in treating UTI. Further investigation is necessary to fully comprehend the mechanisms of action, detection, and description of bioactive compounds, particularly against human pathogens.
Keywords
Article Details
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References
- Abubakar AR, Haque M (2020). Preparation of medicinal plants: Basic extraction and fractionation procedures for experimental purposes. Journal of Pharmacy & Bioallied Sciences 12, 1–10. doi: 10.4103/jpbs.JPBS_175 _19.
- Ahmed O, Mohamed H, Salem W, et al (2021). Efficacy of ethanolic extract of Syzygium aromaticum in the treatment of multidrug-resistant Pseudomonas aeruginosa clinical isolates associated with urinary tract infections ed. Li X. Evidence-Based Complementary and Alternative Medicine 2021, 1–12. doi: 10.1155/2021/661205 8.
- Băicuș A, Mattuzzi FC, Paraschiv AM, et al (2022). Antibacterial activity of clove, oregano, thyme, eucalyptus, and tea tree essential oils against Escherichia coli and Klebsiella pneumoniae strains. Revista Romana de Medicina de Laborator 30, 327–338. doi: 10.2478/rrlm-2022-0023.
- Błaszczyk N, Rosiak A, Kałużna-Czaplińska J (2021). The potential role of cinnamon in human health. Forests 12, 648. doi: 10.3390/f12050648.
- Cui H, Zhao C, Lin L (2015). The specific antibacterial activity of liposome-encapsulated Clove oil and its application in tofu. Food Control 56, 128–134. doi: 10.1016/j.foodcont.2015.03. 026.
- Daro P, Hiariej A, Nindatu M (2020). Traditional medicine plants of Waai village communities, Maluku Province. RUMPHIUS Pattimura Biological Journal 2, 60–65. doi: 10.30598/rumphi usv2i2p060-065.
- Dhore MR, Jha AR (2019). Antimicrobial activity of Allium cepa and Cinnamomum zeylanicum against common bacteria causing urinary tract infections: in vitro study. International Journal of Basic & Clinical Pharmacology 8, 1185. doi: 10.18203/2319-2003.ijbcp20192182.
- Ebani VV, Nardoni S, Bertelloni F, et al (2018). Antimicrobial activity of five essential oils against bacteria and fungi responsible for urinary tract infections. Molecules 23, 1668. doi: 10.3390/molecules23071668.
- Jafarzadeh MM, Mehdipour Moghaddam MJ, Bakhshi D (2020). Antimicrobial activity of three plant species against multi-drug resistant E. coli causing urinary tract infection. Journal of Herbal Medicine 22, 100352. doi: 10.1016/j.hermed.2020.100352.
- Kaewkod T, Tobe R, Tragoolpua Y, et al. (2021). Medicinal plant extracts protect epithelial cells from infection and DNA damage caused by colibactin‐producing Escherichia coli , and inhibit the growth of bacteria. Journal of Applied Microbiology 130, 769–785. doi: 10.1111/jam.1 4817.
- Karam MRA, Habibi M, Bouzari S (2019). Urinary tract infection: Pathogenicity, antibiotic resistance and development of effective vaccines against Uropathogenic Escherichia coli. Molecular Immunology 108, 56–67. doi: 10.1016/j.molimm. 2019.02.007.
- Khatri P, Rani A, Hameed S, et al. (2023). Current understanding of the molecular basis of spices for the development of potential antimicrobial medicine. Antibiotics 12, 270. doi: 10.3390/antibiotics12020270.
- Khosravani M, Soltan Dallal MM, Norouzi M (2020). Phytochemical composition and anti-efflux pump activity of hydroalcoholic, aqueous, and hexane extracts of artemisia tournefortiana in ciprofloxacin-resistant strains of Salmonella enterica serotype enteritidis. Iranian Journal of Public Health. doi: 10.18502/ijph.v49i1.3060.
- Kidane A, Rezene A, Hannes OG, et al (2019). Antibacterial activities of selected medicinal plants against multi-drug resistant bacteria isolated from urine samples of catheterized patients. Clinical Microbiology 8, 1–9. Available at: https://www.walshmedicalmedia.com/open-acces s/antibacterial-activities-of-selected-medicinal-pl ants-against-multidrug-resistant-bacteria-isolated-from-urine-samples-o.pdf.
- Kiran Z, Khan HN, Rasheed S, et al (2023). Isolation of secondary metabolites from Syzygium aromaticum (L.) Merr. & L.M.Perry. (cloves), and evaluation of their biological activities. Natural Product Research 37, 2018–2023. doi: 10.1080/14786419.2022.2112956.
- Loose M, Pilger E, Wagenlehner F (2020). Anti-bacterial effects of essential oils against uropathogenic bacteria. Antibiotics 9, 358. doi: 10.3390/antibiotics9060358.
- Ma’rufi I, Ali K, Jati SK, et al (2020). Improvement of nutritional status among tuberculosis patients by Channa striata supplementation: A true experimental study in Indonesia. BioMed Research International 2020, 7491702. doi: 10.1155/2020/7491702.
- Malau UN, Adipireno P (2019). Leukocyte esterase and nitrite correlation test with urine culture in urinary tract infections. Intisari Sains Medis. doi: 10.15562/ism.v10i1.343.
- Maryani H, Kristiana L, Paramita A, et al (2021). Grouping provinces based on communicable and non-communicable diseases for disease control efforts using a multidimensional scaling (MDS) approach. Buletin Penelitian Sistem Kesehatan 24, 213–225. doi: 10.22435/hsr.v24i3.4196.
- Mayekar VM, Ali A, Alim H, et al (2021). A review: Antimicrobial activity of the medicinal spice plants to cure human disease. Plant Science Today. doi: 10.14719/pst.2021.8.3.1152.
- Mickymaray S, Al Aboody MS (2019). In vitro antioxidant and bactericidal efficacy of 15 common spices: Novel therapeutics for urinary tract infections? Medicina (B Aires) 55, 289. doi: 10.3390/medicina55060289.
- Muhammad A, Nurulita NA, Budiman A (2018). Antibiotic sensitivity test against bacteria causing urinary tract infections in hospitalized patients at Prof. Dr. Margono Soekarjo Purwokerto Regional Hospital.PHARMACY: Jurnal Farmasi Indonesia (Pharmaceutical Journal of Indonesia) 14, 247. doi: 10.30595/pharmacy.v14i2.1684.
- Mytle N, Anderson GL, Doyle MP, et al (2006). Antimicrobial activity of clove (Syzgium aromaticum) oil in inhibiting Listeria monocytogenes on chicken frankfurters. Food Control 17, 102–107. doi: 10.1016/j.foodcont.200 4.09.008.
- Narayanan A, Muyyarikkandy MS, Mooyottu S, et al (2017). Oral supplementation of trans-cinnamaldehyde reduces uropathogenic Escherichia coli colonization in a mouse model. Letters in Applied Microbiology 64, 192–197. doi: 10.1111/lam.12713.
- Nasr A, Khan TS, Huang S-P, et al (2019). Comparison among five eucalyptus species based on their leaf contents of some primary and secondary metabolites. Current Pharmaceutical Biotechnology 20, 573–587. doi: 10.2174/1389201020666190610100122.
- Noreen S, Aslam B, Alina Z, et al (2018). Antibacterial activity of medicinal plants (clove, cinnamon, garlic) extracts and their combined effect with antibiotics in urinary tract infection caused by Escherichia coli.International Journal of Pharmaceutics & Pharmacology 2, 1–14. doi: 10.31531/2581-3080.1000128.
- Nuñez L, D’Aquino M (2012). Microbicide activity of clove essential oil (Eugenia caryophyllata). Brazilian Journal of Microbiology 43, 1255–1260. doi: 10.1590/S1517-83822012000400003.
- Odoki M, Almustapha Aliero A, Tibyangye J, et al (2019). Prevalence of bacterial urinary tract infections and associated factors among patients attending hospitals in Bushenyi District, Uganda. International Journal of Microbiology 2019, 1–8. doi: 10.1155/2019/4246780.
- Oros D, Ceprnja M, Zucko J, et al (2020). Identification of pathogens from native urine samples by MALDI-TOF/TOF tandem mass spectrometry. Clinical Proteomics 17, 25. doi: 10.1186/s12014-020-09289-4.
- Pangaribuan GJ (2013). Description of the level of knowledge of urinary tract infection sufferers about urinary tract infections in the Internal Medicine Polyclinic at the Haji Adam Malik Central General Hospital, Medan, 2019. Jurusan Keperawatan Poltekes Kemenkes Medan1–12. Available at: http://poltekkes.aplikasi-akademik.c om/xmlui/handle/123456789/2154.
- Prakash D, Saxena RS (2013). Distribution and antimicrobial susceptibility pattern of bacterial pathogens causing urinary tract infection in Urban Community of Meerut City, India. ISRN Microbiology 2013, 1–13. doi: 10.1155/2013/ 749629.
- Rachmawati S, Oktima W, Andareas P (2021). Antimicrobial activity test of lemon leaf fractions (Citrus limon (L.) Osbeck) against Stapylococcus aureus and Escherichia coli. Jurnal Pro-Life 8, 72–81. doi: 10.33541/jpvol6Iss2pp102.
- Rao PV, Gan SH (2014). Cinnamon: A multifaceted medicinal plant ed. Kamal MA. Evidence-Based Complementary and Alternative Medicine. doi: 10.1155/2014/642942.
- Ritonga EP (2018). Efforts to prevent urinary tract infections by nurses in catheterized patients at the Imelda Indonesian Workers General Hospital, Medan. Jurnal Ilmiah Keperawatan Imelda 4, 62–67.doi: 10.52943/jikeperawatan.v4i1.286.
- Rohadi D, Ahidin D, Desiyanti D (2021). Inhibitory test of ethanol extract of pandanus leaves (Pleomele angustifolia N. E. Brown) against the growth of Staphylococcus aureus bacteria. Medical Sains : Jurnal Ilmiah Kefarmasian 5, 99–106. doi: 10.37874/ms.v5i2.195.
- Rostinawati T (2021). Antibiotic resistance patterns of bacteria causing urinary tract infections at the Ibrahim Adjie Community Health Center, Bandung City. Jurnal Sains Farmasi & Klinis 8, 27. doi: 10.25077/jsfk.8.1.27-34.2021.
- Saudi ADA (2018). Test of the inhibitory power of antibiotics against bacteria that cause urinary tract infections at Salewangang Maros Hospital. Media Farmasi 14, 27. doi: 10.32382/mf.v14i2.587.
- Shaheen G, Akram M, Jabeen F, et al (2019). Therapeutic potential of medicinal plants for the management of urinary tract infection: A systematic review. Clinical and Experimental Pharmacology and Physiology 46, 613–624. doi: 10.1111/1440-1681.13092.
- Swamy MK, Akhtar MS, Sinniah UR (2016). Antimicrobial properties of plant essential oils against human pathogens and their mode of action: An updated review ed. Avato P. Evidence-Based Complementary and Alternative Medicine. doi: 10.1155/2016/3012462.
- Thiyagarajan S, John S (2020). Antimicrobial activity of Cinnamomum zeylanicum aqueous extract against bacteria and fungi responsible for urinary tract infection.International Journal of Health & Allied Sciences 9, 229. doi: 10.4103/ijhas.IJHAS_3_20.
- Utchariyakiat I, Surassmo S, Jaturanpinyo M, et al (2016). Efficacy of cinnamon bark oil and cinnamaldehyde on anti-multidrug resistant Pseudomonas aeruginosa and the synergistic effects in combination with other antimicrobial agents. BMC Complementary and Alternative Medicine 16, 158. doi: 10.1186/s12906-016-1134-9.
- Vasconcelos NG, Croda J, Simionatto S (2018). Antibacterial mechanisms of cinnamon and its constituents: A review. Microbial Pathogenesis 120, 198–203. doi: 10.1016/j.micpath.2018.04. 036.
- World Health Organization (2019). WHO global report on traditional and complementary medicine 2019. WHO. Available at: https://www.who.int/ publications/i/item/978924151536.
- World Health Organization (2020). Record number of countries contribute data revealing disturbing rates of antimicrobial resistance. WHO. Available at: https://www.who.int/news/item/01-06-2020-record-number-of-countries-contribute-data-revealing-disturbing-rates-of-antimicrobial-resistance.
References
Abubakar AR, Haque M (2020). Preparation of medicinal plants: Basic extraction and fractionation procedures for experimental purposes. Journal of Pharmacy & Bioallied Sciences 12, 1–10. doi: 10.4103/jpbs.JPBS_175 _19.
Ahmed O, Mohamed H, Salem W, et al (2021). Efficacy of ethanolic extract of Syzygium aromaticum in the treatment of multidrug-resistant Pseudomonas aeruginosa clinical isolates associated with urinary tract infections ed. Li X. Evidence-Based Complementary and Alternative Medicine 2021, 1–12. doi: 10.1155/2021/661205 8.
Băicuș A, Mattuzzi FC, Paraschiv AM, et al (2022). Antibacterial activity of clove, oregano, thyme, eucalyptus, and tea tree essential oils against Escherichia coli and Klebsiella pneumoniae strains. Revista Romana de Medicina de Laborator 30, 327–338. doi: 10.2478/rrlm-2022-0023.
Błaszczyk N, Rosiak A, Kałużna-Czaplińska J (2021). The potential role of cinnamon in human health. Forests 12, 648. doi: 10.3390/f12050648.
Cui H, Zhao C, Lin L (2015). The specific antibacterial activity of liposome-encapsulated Clove oil and its application in tofu. Food Control 56, 128–134. doi: 10.1016/j.foodcont.2015.03. 026.
Daro P, Hiariej A, Nindatu M (2020). Traditional medicine plants of Waai village communities, Maluku Province. RUMPHIUS Pattimura Biological Journal 2, 60–65. doi: 10.30598/rumphi usv2i2p060-065.
Dhore MR, Jha AR (2019). Antimicrobial activity of Allium cepa and Cinnamomum zeylanicum against common bacteria causing urinary tract infections: in vitro study. International Journal of Basic & Clinical Pharmacology 8, 1185. doi: 10.18203/2319-2003.ijbcp20192182.
Ebani VV, Nardoni S, Bertelloni F, et al (2018). Antimicrobial activity of five essential oils against bacteria and fungi responsible for urinary tract infections. Molecules 23, 1668. doi: 10.3390/molecules23071668.
Jafarzadeh MM, Mehdipour Moghaddam MJ, Bakhshi D (2020). Antimicrobial activity of three plant species against multi-drug resistant E. coli causing urinary tract infection. Journal of Herbal Medicine 22, 100352. doi: 10.1016/j.hermed.2020.100352.
Kaewkod T, Tobe R, Tragoolpua Y, et al. (2021). Medicinal plant extracts protect epithelial cells from infection and DNA damage caused by colibactin‐producing Escherichia coli , and inhibit the growth of bacteria. Journal of Applied Microbiology 130, 769–785. doi: 10.1111/jam.1 4817.
Karam MRA, Habibi M, Bouzari S (2019). Urinary tract infection: Pathogenicity, antibiotic resistance and development of effective vaccines against Uropathogenic Escherichia coli. Molecular Immunology 108, 56–67. doi: 10.1016/j.molimm. 2019.02.007.
Khatri P, Rani A, Hameed S, et al. (2023). Current understanding of the molecular basis of spices for the development of potential antimicrobial medicine. Antibiotics 12, 270. doi: 10.3390/antibiotics12020270.
Khosravani M, Soltan Dallal MM, Norouzi M (2020). Phytochemical composition and anti-efflux pump activity of hydroalcoholic, aqueous, and hexane extracts of artemisia tournefortiana in ciprofloxacin-resistant strains of Salmonella enterica serotype enteritidis. Iranian Journal of Public Health. doi: 10.18502/ijph.v49i1.3060.
Kidane A, Rezene A, Hannes OG, et al (2019). Antibacterial activities of selected medicinal plants against multi-drug resistant bacteria isolated from urine samples of catheterized patients. Clinical Microbiology 8, 1–9. Available at: https://www.walshmedicalmedia.com/open-acces s/antibacterial-activities-of-selected-medicinal-pl ants-against-multidrug-resistant-bacteria-isolated-from-urine-samples-o.pdf.
Kiran Z, Khan HN, Rasheed S, et al (2023). Isolation of secondary metabolites from Syzygium aromaticum (L.) Merr. & L.M.Perry. (cloves), and evaluation of their biological activities. Natural Product Research 37, 2018–2023. doi: 10.1080/14786419.2022.2112956.
Loose M, Pilger E, Wagenlehner F (2020). Anti-bacterial effects of essential oils against uropathogenic bacteria. Antibiotics 9, 358. doi: 10.3390/antibiotics9060358.
Ma’rufi I, Ali K, Jati SK, et al (2020). Improvement of nutritional status among tuberculosis patients by Channa striata supplementation: A true experimental study in Indonesia. BioMed Research International 2020, 7491702. doi: 10.1155/2020/7491702.
Malau UN, Adipireno P (2019). Leukocyte esterase and nitrite correlation test with urine culture in urinary tract infections. Intisari Sains Medis. doi: 10.15562/ism.v10i1.343.
Maryani H, Kristiana L, Paramita A, et al (2021). Grouping provinces based on communicable and non-communicable diseases for disease control efforts using a multidimensional scaling (MDS) approach. Buletin Penelitian Sistem Kesehatan 24, 213–225. doi: 10.22435/hsr.v24i3.4196.
Mayekar VM, Ali A, Alim H, et al (2021). A review: Antimicrobial activity of the medicinal spice plants to cure human disease. Plant Science Today. doi: 10.14719/pst.2021.8.3.1152.
Mickymaray S, Al Aboody MS (2019). In vitro antioxidant and bactericidal efficacy of 15 common spices: Novel therapeutics for urinary tract infections? Medicina (B Aires) 55, 289. doi: 10.3390/medicina55060289.
Muhammad A, Nurulita NA, Budiman A (2018). Antibiotic sensitivity test against bacteria causing urinary tract infections in hospitalized patients at Prof. Dr. Margono Soekarjo Purwokerto Regional Hospital.PHARMACY: Jurnal Farmasi Indonesia (Pharmaceutical Journal of Indonesia) 14, 247. doi: 10.30595/pharmacy.v14i2.1684.
Mytle N, Anderson GL, Doyle MP, et al (2006). Antimicrobial activity of clove (Syzgium aromaticum) oil in inhibiting Listeria monocytogenes on chicken frankfurters. Food Control 17, 102–107. doi: 10.1016/j.foodcont.200 4.09.008.
Narayanan A, Muyyarikkandy MS, Mooyottu S, et al (2017). Oral supplementation of trans-cinnamaldehyde reduces uropathogenic Escherichia coli colonization in a mouse model. Letters in Applied Microbiology 64, 192–197. doi: 10.1111/lam.12713.
Nasr A, Khan TS, Huang S-P, et al (2019). Comparison among five eucalyptus species based on their leaf contents of some primary and secondary metabolites. Current Pharmaceutical Biotechnology 20, 573–587. doi: 10.2174/1389201020666190610100122.
Noreen S, Aslam B, Alina Z, et al (2018). Antibacterial activity of medicinal plants (clove, cinnamon, garlic) extracts and their combined effect with antibiotics in urinary tract infection caused by Escherichia coli.International Journal of Pharmaceutics & Pharmacology 2, 1–14. doi: 10.31531/2581-3080.1000128.
Nuñez L, D’Aquino M (2012). Microbicide activity of clove essential oil (Eugenia caryophyllata). Brazilian Journal of Microbiology 43, 1255–1260. doi: 10.1590/S1517-83822012000400003.
Odoki M, Almustapha Aliero A, Tibyangye J, et al (2019). Prevalence of bacterial urinary tract infections and associated factors among patients attending hospitals in Bushenyi District, Uganda. International Journal of Microbiology 2019, 1–8. doi: 10.1155/2019/4246780.
Oros D, Ceprnja M, Zucko J, et al (2020). Identification of pathogens from native urine samples by MALDI-TOF/TOF tandem mass spectrometry. Clinical Proteomics 17, 25. doi: 10.1186/s12014-020-09289-4.
Pangaribuan GJ (2013). Description of the level of knowledge of urinary tract infection sufferers about urinary tract infections in the Internal Medicine Polyclinic at the Haji Adam Malik Central General Hospital, Medan, 2019. Jurusan Keperawatan Poltekes Kemenkes Medan1–12. Available at: http://poltekkes.aplikasi-akademik.c om/xmlui/handle/123456789/2154.
Prakash D, Saxena RS (2013). Distribution and antimicrobial susceptibility pattern of bacterial pathogens causing urinary tract infection in Urban Community of Meerut City, India. ISRN Microbiology 2013, 1–13. doi: 10.1155/2013/ 749629.
Rachmawati S, Oktima W, Andareas P (2021). Antimicrobial activity test of lemon leaf fractions (Citrus limon (L.) Osbeck) against Stapylococcus aureus and Escherichia coli. Jurnal Pro-Life 8, 72–81. doi: 10.33541/jpvol6Iss2pp102.
Rao PV, Gan SH (2014). Cinnamon: A multifaceted medicinal plant ed. Kamal MA. Evidence-Based Complementary and Alternative Medicine. doi: 10.1155/2014/642942.
Ritonga EP (2018). Efforts to prevent urinary tract infections by nurses in catheterized patients at the Imelda Indonesian Workers General Hospital, Medan. Jurnal Ilmiah Keperawatan Imelda 4, 62–67.doi: 10.52943/jikeperawatan.v4i1.286.
Rohadi D, Ahidin D, Desiyanti D (2021). Inhibitory test of ethanol extract of pandanus leaves (Pleomele angustifolia N. E. Brown) against the growth of Staphylococcus aureus bacteria. Medical Sains : Jurnal Ilmiah Kefarmasian 5, 99–106. doi: 10.37874/ms.v5i2.195.
Rostinawati T (2021). Antibiotic resistance patterns of bacteria causing urinary tract infections at the Ibrahim Adjie Community Health Center, Bandung City. Jurnal Sains Farmasi & Klinis 8, 27. doi: 10.25077/jsfk.8.1.27-34.2021.
Saudi ADA (2018). Test of the inhibitory power of antibiotics against bacteria that cause urinary tract infections at Salewangang Maros Hospital. Media Farmasi 14, 27. doi: 10.32382/mf.v14i2.587.
Shaheen G, Akram M, Jabeen F, et al (2019). Therapeutic potential of medicinal plants for the management of urinary tract infection: A systematic review. Clinical and Experimental Pharmacology and Physiology 46, 613–624. doi: 10.1111/1440-1681.13092.
Swamy MK, Akhtar MS, Sinniah UR (2016). Antimicrobial properties of plant essential oils against human pathogens and their mode of action: An updated review ed. Avato P. Evidence-Based Complementary and Alternative Medicine. doi: 10.1155/2016/3012462.
Thiyagarajan S, John S (2020). Antimicrobial activity of Cinnamomum zeylanicum aqueous extract against bacteria and fungi responsible for urinary tract infection.International Journal of Health & Allied Sciences 9, 229. doi: 10.4103/ijhas.IJHAS_3_20.
Utchariyakiat I, Surassmo S, Jaturanpinyo M, et al (2016). Efficacy of cinnamon bark oil and cinnamaldehyde on anti-multidrug resistant Pseudomonas aeruginosa and the synergistic effects in combination with other antimicrobial agents. BMC Complementary and Alternative Medicine 16, 158. doi: 10.1186/s12906-016-1134-9.
Vasconcelos NG, Croda J, Simionatto S (2018). Antibacterial mechanisms of cinnamon and its constituents: A review. Microbial Pathogenesis 120, 198–203. doi: 10.1016/j.micpath.2018.04. 036.
World Health Organization (2019). WHO global report on traditional and complementary medicine 2019. WHO. Available at: https://www.who.int/ publications/i/item/978924151536.
World Health Organization (2020). Record number of countries contribute data revealing disturbing rates of antimicrobial resistance. WHO. Available at: https://www.who.int/news/item/01-06-2020-record-number-of-countries-contribute-data-revealing-disturbing-rates-of-antimicrobial-resistance.