Unveiling the synergistic potency of chlorhexidine and azithromycin in combined action

Samgane G., Karaçam S., Tunçer Çağlayan S.

Naunyn-Schmiedeberg's Archives of Pharmacology, vol.397, no.8, pp.5975-5987, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 397 Issue: 8
  • Publication Date: 2024
  • Doi Number: 10.1007/s00210-024-03010-0
  • Journal Name: Naunyn-Schmiedeberg's Archives of Pharmacology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Biotechnology Research Abstracts, CAB Abstracts, Chemical Abstracts Core, Chimica, Veterinary Science Database
  • Page Numbers: pp.5975-5987
  • Keywords: Azithromycin, Chlorhexidine, Flagellin, Growth inhibition, NF-κB, TLR5
  • Bilecik Şeyh Edebali University Affiliated: Yes

Abstract

The growing challenge of antibiotic resistance necessitates novel approaches for combating bacterial infections. This study explores the distinctive synergy between chlorhexidine, an antiseptic and disinfectant agent, and azithromycin, a macrolide antibiotic, in their impact on bacterial growth and virulence factors using Escherichia coli strain Crooks (ATCC 8739) as a model. Our findings reveal that the chlorhexidine and azithromycin combination demonstrates enhanced anti-bacterial effects compared to individual treatments. Intriguingly, the combination induced oxidative stress, decreased flagellin expression, impaired bacterial motility, and enhanced bacterial autoaggregation. Notably, the combined treatment also demonstrated a substantial reduction in bacterial adherence to colon epithelial cells and downregulated NF-κB in the epithelial cells. In conclusion, these results shed light on the potential of the chlorhexidine and azithromycin synergy as a compelling strategy to address the rising challenge of antibiotic resistance and may pave the way for innovative therapeutic interventions in tackling bacterial infections.