SYNERGISTIC ANTIBACTERIAL EFFECTS OF CIPROFLOXACIN, CEFTAZIDIME, AND BACTERIOCIN COMBINATIONS AGAINST MULTIDRUG-RESISTANT ESCHERICHIA COLI

Objectives: Antibiotic-resistant bacteria are an irritating health issue that has killed lots of people in recent years. The developing resistance of bacteria to new antibiotics, including misuse by patients, is a major issue for medication industries. Researchers are discovering alternatives to developing new antibiotics, such as generating combinations of antibiotics or biological mixtures to inhibit bacterial growth. The study aimed to determine the effect of the combination of antibiotics (ciprofloxacin [CIP] with ceftazidime [CAZ]) and each antibiotic CAZ/CIP with bacteriocin on the Escherichia coli. Methods: A total of 30 samples were collected from patients with urinary tract infections and burn injuries for this study. After determining all isolate species via the Vitek2 system, the minimum inhibitory concentration values were determined for CIP/CAZ and CIP/bacteriocin, CAZ/bacteriocin combination on 10 Multidrug-resistant (MDR) E. coli. Moreover, the expression level of Gyrase A and Gyrase B genes from 10 selected isolates of E. coli was measured using quantitative real-time polymerase chain reaction. Results: The antibacterial activity showed a highly significant difference in isolates treated with CIP/CAZ and CIP/bacteriocin, CAZ/bacteriocin combination compared to those treated with each antibiotic alone (p≤0.05). The gene expression for Gyrase A and Gyrase B revealed a significant reduction when using CIP/CAZ and bacteriocin with each antibiotic compared to control isolates (p≤0.05). Conclusion: The combination of CIP/CAZ and bacteriocin with CIP and CAZ exposed a significant effect against MDR isolates; initial new approaches in combating MDR E. coli, particularly when combined with highly effective biological agents such as peptides or adjuvant.