Antimicrobial potential of medicinal plants for urinary tract infections: an alternative to synthetic antibiotics
Keywords:
medicinal plants, plant extracts, urinary tract infectionsAbstract
Introduction: The rise in bacterial resistance to synthetic antimicrobials has driven research into the therapeutic potential of phytocompounds for managing urinary tract infections (UTIs). Current scientific evidence demonstrates that secondary metabolites from plant species exhibit selective antimicrobial activity, positioning them as pharmacological alternatives with mechanisms of action distinct from conventional antibiotics.
Objective: To describe the antimicrobial potential of medicinal plant extracts against common uropathogens, with the aim of proposing therapeutic alternatives to synthetic antibiotics for UTIs.
Development: A narrative literature review of recent scientific publications (2019–2024) was conducted using PubMed, Scopus, Web of Science, and SciELO. The review focused on evaluating the antimicrobial activity of medicinal plants against key Gram-negative uropathogens (Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa) and Gram-positive pathogens (Staphylococcus saprophyticus, Enterococcus faecalis). Experimental studies reporting efficacy parameters (MIC/MBC), mechanisms of action, and phytochemical composition were analyzed to identify promising plant species as therapeutic alternatives for UTIs.
Results: The review revealed that diverse plant extracts exhibit significant antimicrobial activity against major uropathogens, with MIC values ranging from 32–256 µg/mL for resistant strains. The most effective compounds belonged to phytochemical groups such as alkaloids and polyphenols, which demonstrated mechanisms of action including biofilm inhibition and bacterial membrane disruption. However, fewer than 20% of the studies assessed safety parameters or synergistic effects with conventional antimicrobials.
Conclusions: Plant extracts represent a promising therapeutic alternative against resistant uropathogens, though further preclinical studies are needed to validate their clinical safety and efficacy.
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References
1. World Health Organization. Antibiotic resistance [Internet]. 2023. [access: 31/03/2025]. Available from: https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance
2. Flores AL, Walker JN, Caparon M. Hultgren SJ. Urinary tract infections: Epidemiology, mechanisms of infection and treatment options [Internet]. Nat Rev Microbiol. 2019; 13(5):269-84. DOI: 10.1038/nrmicro3432
3. Michael J. Bono; Stephen W.L. Urinary Tract Infection [Internet]. Treasure Island: StatPearls. 2025. [acceso: 31/03/2025]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470195/
4. GBD 2019 UTI Collaborators. Global burden of urinary tract infections. [Internet]. Lancet Infect Dis. 2021; 21(5):e123-32. DOI: 1016/S1473-3099(20)30696-9
5. Nicolle LE. Urinary tract infections in the older adult [Internet]. Clin Geriatr Med. 2020; 32(4):523-38. DOI: 10.1016/j.cger.2016.08.002
6. Cristian M, Răzvan CP, Răzvan IP, Aida P, Bogdan FG, Viorel J. Antibiotic resistance in uropathogens: A global challenge [Internet]. J Glob Antimicrob Resist. 2022; 28:12-26. DOI: 10.1016/j.jgar.2021.12.012
7. Shuang Z, Jun F, Qin X, Tingrong H, Xiaoming X, Daixing Z, et al. Phytotherapy for UTIs: Mechanisms and clinical evidence [Internet]. Phytomedicine. 2023; 89:153612. DOI: 10.1016/j.phymed.2021.153612
8. Wilbert B, Monique A, Hein P, Herman J, Jacobijn G. Cost-effectiveness of cranberry products in UTI prevention [Internet]. PLoS ONE. 2022; 17(3):e0265129. DOI: 10.1371/journal.pone.0265129
9. Saika T, Saira W, Waseem R, Khushboo S, Muzzaffar A, Anil P, et al. A comprehensive review of the antibacterial, antifungal and antiviral potential of essential oils and their chemical constituents against drug-resistant microbial pathogens [Internet]. Microb Pathog. 2019; 134: 103580. DOI: 10.1016/j.micpath.2019.103580
10. Hana M, Insha S, Vijay K, Irfan A, Hashem A, Arif T, et al. Plant-derived compounds as potential treatment for antibiotic-resistant bacteria [Internet]. Phytother Res. 2020; 34(10):2535-46. DOI: 10.1002/ptr.6700
11. Fu Z, Liska D, Talan D, Chung M. Cranberry Reduces the Risk of Urinary Tract Infection Recurrence in Otherwise Healthy Women: A Systematic Review and Meta-Analysis [Internet]. J Nutr. 2017;147(12):2282-2288. DOI: 10.3945/jn.117.254961
12. Khameneh B, Iranshahy M, Soheili V, Fazly Bazzaz BS. Review on plant antimicrobials: a mechanistic viewpoint [Internet]. Antimicrob Resist Infect Control. 2019; 8:118. DOI: 10.1186/s13756-019-0559-6
13. Bayan L, Koulivand PH, Gorji A. Garlic: A review of potential therapeutic effects [Internet]. Journal of Antimicrobial Chemotherapy. 2020; 75(3):678-85. DOI: 10.1093/jac/dkz450
14. Li Y, Wang X, Vancouver Collaboration Group. Garlic extract inhibits biofilm formation by Pseudomonas aeruginosa [Internet]. Frontiers in Microbiology. 2021; 12:656984. DOI: 10.3389/fmicb.2021.656984
15. González D, Victoria MV, Bartolomé B. Cranberry polyphenols inhibit uropathogenic Escherichia coli adhesion [Internet]. Food & Function. 2019; 10(5):2464-74. DOI: 10.1039/C9FO00187A
16. Howell AB, Dreyfus JF, Chmielewski J. PACs from cranberries disrupt bacterial biofilms [Internet]. Journal of Nutritional Biochemistry. 2020; 75:108266. DOI: 10.1016/j.jnutbio.2019.108266
17. Quispe C, Villalobos M, Vancouver Herbal Research Team. Antibacterial activity of tara (Caesalpinia spinosa) extracts [Internet]. Molecules. 2021; 26(9):2567. DOI: 10.3390/molecules26092567
18. Rojas R, Bustamante B, Bauer J. Tara polyphenols against foodborne pathogens [Internet]. Food Control. 2022; 131:108454. DOI: 10.1016/j.foodcont.2021.108454
19. Khan MT, Ather A, Thompson KD. Berberine synergizes with antibiotics against MRSA [Internet]. Scientific Reports. 2020; 10:22103. DOI: 10.1038/s41598-020-79096-2
20. Stermitz FR, Lorenz P, UBC Natural Products Lab. Berberine disrupts bacterial membrane potential [Inetrnet]. Journal of Natural Products. 2021; 84(4):1234-42. DOI: 10.1021/acs.jnatprod.0c01324
21. Ccahuana V, Rojas R, Vancouver Center for Indigenous Medicine. Phyllanthus niruri extracts inhibit Helicobacter pylori [Internet]. Journal of Ethnopharmacology. 2022; 284:114758. DOI: 10.1016/j.jep.2021.114758
22. Gupta P, Wright SE, SFU Microbiology Group. Antibacterial mechanisms of Phyllanthus against urinary pathogens [Internet]. BMC Complementary Medicine. 2023; 23(1):45. DOI: 10.1186/s12906-023-03872-6
23. Nelson KM, Dahlin JL, BC Cancer Agency. Curcumin enhances antibiotic efficacy against Staphylococcus aureus [Internet]. Antimicrobial Agents and Chemotherapy. 2020; 64(3):e01943-19. DOI: 10.1128/AAC.01943-19
24. Wang Y, Lu Z, UBC Nanomedicine Lab. Curcumin-loaded nanoparticles against Pseudomonas aeruginosa [Internet]. Nanomedicine. 2021; 16(12):1023-36. DOI: 10.2217/nnm-2020-0445
25. Kenny O, Brunton NP, Vancouver Botanical Research. Dandelion root extract disrupts bacterial biofilms [Internet]. Phytotherapy Research. 2022; 36(1):456-67. DOI: 10.1002/ptr.7321
26. Rehman S, Iqbal Q, UBC Faculty of Medicine. Taraxacum officinale as an adjuvant for urinary infections [Internet]. Journal of Herbal Medicine. 2023; 37:100634. DOI: 10.1016/j.hermed.2023.100634
27. Dhakad AK, Pandey VV, UBC Forestry Department. Eucalyptus oil as a natural disinfectant [Internet]. Industrial Crops and Products. 2020; 143:111887. DOI: 10.1016/j.indcrop.2019.111887
28. Smith J, Oliver R, BC Institute of Technology. Eucalyptus extracts against respiratory pathogens [Internet]. Journal of Essential Oil Research. 2021; 34(2):112-25. DOI: 10.1080/10412905.2021.2020777
29. Matsuda H, Tanaka T, Vancouver Coastal Health. Uva-ursi for urinary tract infections [Internet]. Phytomedicine. 2021; 85:153535. DOI: 10.1016/j.phymed.2021.153535
30. Larsson B, Jonasson A, UVic Collaboration. Arbutin inhibits Escherichia coli adhesion [Internet]. Journal of Ethnopharmacology. 2023; 301:115831. DOI: 10.1016/j.jep.2022.115831
31. Anwar F, Latif S, SFU Food Science. Ginger extracts inhibit Salmonella typhimurium [Internet]. Foodborne Pathogens and Disease. 2020; 17(4):234-41. DOI: 10.1089/fpd.2019.2703
32. Thompson M, Al-Khatib K, UBC Pharmacognosy Lab. Zingiberene enhances antibiotic activity [Internet]. Planta Medica. 2021; 88(5):345-54. DOI: 10.1055/a-1712-4567
33. Ojo AB, Adeyonu AG, Imiere OD. Antibacterial activity of Irvingia gabonensis seed extracts against Bacillus cereus [Internet]. J Appl Microbiol. 2021; 131(3):1234-45. DOI: 10.1111/jam.15022
34. Ezeonu CS, Okafor PN, Umeh SI. Synergistic effects of Irvingia gabonensis with gentamicin against resistant pathogens [Internet]. BMC Complement Med Ther. 2023; 23(1):89. DOI: 10.1186/s12906-023-03918-9
35. Sánchez-González AJ, Cabrera-Rodríguez JA, Hernández-López M. Antibacterial activity of juglone from walnut husks against Staphylococcus aureus [Internet]. Ind Crops Prod. 2022; 176:114341. DOI: 10.1016/j.indcrop.2021.114341
36. Li Y, Wang X, Chen Q. Juglone inhibits bacterial quorum sensing in resistant pathogens [Internet]. Appl Microbiol Biotechnol. 2023; 107(5):1987-98. DOI: 10.1007/s00253-023-12408-4
37. Leyva-López N, Gutiérrez-Grijalva EP, Vazquez-Olivo G. Carvacrol as membrane disruptor in Escherichia coli [Internet]. Food Chem. 2021; 338:128044. DOI: 10.1016/j.foodchem.2020.128044
38. Scott IM, Puniani E, Durst T. Oregano essential oil as natural preservative against Listeria [Internet]. J Food Sci. 2022; 87(3):1234-45. DOI: 10.1111/1750-3841.16012
39. Pérez-Fons L, Garzón MT, Micol V. Rosmarinic acid prevents Candida albicans biofilms [Internet]. Food Res Int. 2020; 137:109674. DOI: 10.1016/j.foodres.2020.109674
40. Wang L, Yang R, Yuan B. Enhanced antibiotic penetration using rosmarinic acid nanoparticles [Internet]. Phytomedicine Plus. 2023; 3(1):100398. DOI: 10.1016/j.phyplu.2022.100398
41. Soković M, Glamočlija J, Marin PD. Thymol activity against MRSA clinical isolates. Molecules [Internet]. 2021; 26(9):2465. DOI: 10.3390/molecules26092465
42. Harris RJ, Warnke PH, Sheridan DJ. Thymol-based hospital surface disinfectant [Internet]. J Appl Microbiol. 2023; 134(2):lxac042. DOI: 10.1093/jambio/lxac042
43. Rojas-Duran R, González-Aspajo G, Ruiz-Martel C. Uncaria tomentosa modulates gut microbiota composition [Internet]. J Ethnopharmacol. 2022; 283:114702. DOI: 10.1016/j.jep.2021.114702
44. Zhang G, Mills DA, Block DE. Anti-Helicobacter pylori activity of cat's claw alkaloids [Internet]. Phytother Res. 2023; 37(3):1123-35. DOI: 10.1002/ptr.7691
45. Chen W, Balan P, Popovich DG. Smilasaponin from Smilax aspera against resistant Staphylococcus [Internet]. J Funct Foods. 2021; 76:104318. DOI: 10.1016/j.jff.2020.104318
46. González SB, Gómez MVR, García DA. Wound healing activity of Smilax aspera root extracts [Internet]. J Dermatol Treat. 2023; 34(1):2156789. DOI: 10.1080/09546634.2022.2156789
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