LAUSR

AIMS Antimicrobial resistance continues to be a growing concern, resulting in increased use of drug combinations. Antibiotic adjuvants are an emerging strategy that may potentiate an antibiotics efficacy. Ibuprofen's polypharmacological properties have been investigated for their antimicrobial and host-modulating potential. This study aimed to investigate the potential of a novel multidrug combination involving ibuprofen, essential oil compounds and conventional antimicrobials against skin pathogens. METHODS The minimum inhibitory concentrations of ibuprofen, conventional antimicrobials, and essential oil compounds were determined and then combined and tested against 14 (reference and clinical) skin pathogens. The cytotoxicity was analysed using the MTT assay, whilst the anti-inflammatory effects were evaluated using lipopolysaccharide activated RAW264.7 murine macrophages. RESULTS Four pairwise (Ibuprofen and antibiotic) (ΣFIC 0.33-0.50) and three triple (Ibuprofen and antibiotic with essential oil compound) (ΣFIC 0.44-0.47) synergistic antimicrobial interactions were identified. These combinations demonstrated cell viability of 77.59-100%. No combination significantly reduced nitric oxide production. CONCLUSION The results from this study provide insight into the potential of a multidrug combination involving ibuprofen with conventional antimicrobials and essential oil compounds against common skin pathogens.