Synergism of ibubrofen with ciprofloxacin against ciprofloxacin resistant Pseudomona aeruginosa through bacterial biofilm inhibition

Background and Aim : Infection with drug-resistant Pseudomonas aeruginosa strains is a major health challenge, worldwide. Biofilm formation by bacterial strains is regarded as a main cause of non-specific resistance to a variety of antimicrobial agents and thus, therapeutic failure. Inhibition of bacterial biofilm is a novel approach to combat the drug resistance phenotype of pathogenic bacteria. Previous studies reported the antibiofilm potential of Non-steroidal anti-inflammatory drugs (NSAIDs) drugs. Therefore, NSAIDs could show synergism with antibiotics against drug-resistant strains through their antibiofilm potential. Therefore, the current work was conducted to evaluate antibiofilm potential and synergism with ciprofloxacin against cirprofloxacin resistant P. aeruginosa strains.Methods : Bacterial strains were isolated from clinical specimens and identified using biochemical assays. Ciprofloxacin resistance was determined using disk diffusion method. Also, the minimum inhibitory concentration (MIC) of ibubrofen and ciprofloxacin was determined in ۹۶-well microtiter plates. The antibiofilm potential of ibubrofen at sub-MIC concentration was determined using the crystal violet staining assay in ۹۶-well plates. Finally, the synergism of the ibubrofen and ciprofloxacin was investigated using the checkerboard titration assay.Results : The isolated strains were Gram-negative, catalase and oxidase positive rods, able to grow in cetrimide agar and also at ۴۲?C. The MICs of ibubrofen and ciprofloxacin were determined ۲۰۴۸ and ۳۲ µg/mL, respectively. At ½ MIC, ibubrofen significantly reduced biofilm formation by ۳۴-۵۶%, compared with the control. Finally, the checkerboard titration assay revealed synergism of the drugs with fractional inhibitory concentration (FIC) of ۰.۳۷.Conclusion : This work showed the synergism of Ibubrofen with ciprofloxacin against ciprofloxacin resistant P. aeruginosa strains which could be associated with the antibiofilm activity of ibubrofen. Our results indicated that combined therapy using ibubrofen and ciprofloxacin could be a promising approach against drug-resistant P. aeruginosa infection, after further characterization.

کلیدواژه ها:

ibubrofen ، biofilm ، Pseudomonas aeruginosa ، antibiotic