Phytochemistry Reviews

, Volume 15, Issue 4, pp 651–662 | Cite as

Synergism between antibiotics and plant extracts or essential oils with efflux pump inhibitory activity in coping with multidrug-resistant staphylococci

  • Mária Mikulášová
  • Romana Chovanová
  • Štefánia Vaverková


The alarming growth of the number of antibiotic resistant bacteria and in the same time limited possibilities to develop new antimicrobial compounds, lead to an urgent need to keep the sensitivity of bacteria against currently used antibiotics. Bacterial efflux pumps are an important mechanism of antibiotic resistance as the bacteria use efflux pumps for the extrusion of different types of antibiotics and chemicals. The knowledge about inhibitors of efflux pumps from natural sources suggests that this mechanism may be a good target for new drugs based on synergistic interactions of antibiotics with plant extracts, essential oils, or their constituents with efflux pump inhibitory activity. This review summarizes the current knowledge of staphylococcal efflux pumps and potential strategies to overcome them. Natural inhibitors of efflux pumps and their synergistic interactions with antibiotics are summarized.


Efflux pump inhibitor Antibiotic resistance Plant extract Essential oil 



Essential oil


Efflux pump


Efflux pump inhibitor


Ethidium bromide


Multidrug resistance





The work was supported by a Grant VEGA 1/0287/15. Authors are grateful to Dr. Milen Georgiev for the invitation to submit this review.


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© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  1. 1.Department of Molecular Biology, Faculty of Natural ScienceComenius UniversityBratislavaSlovak Republic
  2. 2.Department of Pharmacognosy and Botany, Faculty of PharmacyComenius UniversityBratislavaSlovak Republic

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