Synergistic Antimicrobial Activity of Ceftriaxone and Methanol (MEPL) Leaf Extract against Methicillin-Resistant and Modulation of Gene Presence.

Medicinal plants are an essential source of traditional curatives for numerous skin diseases. (Sonn.) Thwaites (Annonaceae family) used to cure skin illnesses. is usually applied in folkloric therapeutical systems to treat skin diseases. The methicillin-resistant (MRSA) bacteria is among the essential bacteria contributing to skin diseases. Hence, to verify the traditional medicinal claim of usage in skin disease treatment, the current research was performed to study the synergistic antibacterial activity of standardized methanol leaf extract (MEPL) against MRSA bacteria. The synergistic antimicrobial activity result of ceftriaxone, when mixed with MEPL, against MRSA was investigated by the disc diffusion method, broth microdilution method, checkerboard dilution test, and modulation of gene expression by multiplex polymerase chain reaction (multiplex PCR). The MEPL extract exhibited good antimicrobial activity against MRSA. Using the checkerboard method, we confirmed the synergistic effect of MEPL from and ceftriaxone (2:1) for MRSA with a marked reduction of the MIC value of the ceftriaxone from 8000 µg/mL to 1000 µg/mL. Moreover, the combination of MEPL with ceftriaxone significantly ( < 0.05) inhibited the presence of the resistant gene in the tested strain. The LC-ESI-MS/MS analysis identified compounds that were reported to exhibit antimicrobial activity. Conclusively, the MEPL extract, an important etiological agent for skin diseases, showed worthy synergistic antimicrobial action against MRSA bacteria, thus supporting the traditional use of .