Cannabinoids as Antibacterial Agents: A Systematic and Critical Review of In Vitro Efficacy Against Streptococcus and
Dhakshila Niyangoda1,2, Myat Lin Aung1, Mallique Qader3
1Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia.
Background:
Two major bacterial pathogens, Staphylococcus aureus and Streptococcus pyogenes, are becoming increasingly antibiotic-resistant. Despite the urgency, only a few new antibiotics have been approved to address these infections. Although cannabinoids have been noted for their antibacterial properties, a comprehensive review of their effects on these bacteria has been lacking.
Objective:
This systematic review examines the antibacterial activity of cannabinoids against S. aureus, including methicillin-resistant S. aureus (MRSA) and vancomycin-resistant S. aureus (VRSA) strains, and S. pyogenes.
Methods:
Databases, including CINAHL, Cochrane, Medline, Scopus, Web of Science, and LILACS, were searched. Of 3510 records, 24 studies met the inclusion criteria, reporting on the minimum inhibitory concentration (MIC) and minimum bactericidal concentration of cannabinoids.
Results:
Cannabidiol (CBD) emerged as the most effective cannabinoid, with MICs ranging from 0.65 to 32 mg/L against S. aureus, 0.5 to 4 mg/L for MRSA, and 1 to 2 mg/L for VRSA. Other cannabinoids, such as cannabichromene, cannabigerol (CBG), and delta-9-tetrahydrocannabinol (Δ9-THC), also exhibited significant antistaphylococcal activity. CBD, CBG, and Δ9-THC also showed efficacy against S. pyogenes, with MICs between 0.6 and 50 mg/L. Synergistic effects were observed when CBD and essential oils from Cannabis sativa when combined with other antibacterial agents.
Conclusion:
Cannabinoids' antibacterial potency is closely linked to their structure-activity relationships, with features like the monoterpene region, aromatic alkyl side chain, and aromatic carboxylic groups enhancing efficacy, particularly in CBD and its cyclic forms. These results highlight the potential of cannabinoids in developing therapies for resistant strains, though further research is needed to confirm their clinical effectiveness.
Insights
Cannabinoids show significant antibacterial activity against antibiotic-resistant bacteria like Staphylococcus aureus and Streptococcus pyogenes. Cannabidiol (CBD) is particularly effective, offering potential for new therapies against these challenging infections.
Area of Science:
- Microbiology
- Pharmacology
- Natural Products Chemistry
Background:
- Increasing antibiotic resistance in Staphylococcus aureus and Streptococcus pyogenes poses a significant public health threat.
- Limited development of novel antibiotics necessitates exploration of alternative therapeutic agents.
- Cannabinoids possess known antibacterial properties that warrant a comprehensive review.
Purpose of the Study:
- To systematically review the antibacterial activity of cannabinoids against Staphylococcus aureus (including MRSA and VRSA) and Streptococcus pyogenes.
- To identify specific cannabinoids with potent antimicrobial effects.
- To understand the structure-activity relationships influencing cannabinoid efficacy.
Main Methods:
- Systematic literature search across multiple databases (CINAHL, Cochrane, Medline, Scopus, Web of Science, LILACS).
- Inclusion of 24 studies reporting minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) data.
- Analysis of cannabinoid efficacy against target bacterial strains.
Main Results:
- Cannabidiol (CBD) demonstrated potent activity against S. aureus, MRSA, and VRSA, with low MIC values.
- Other cannabinoids, including cannabigerol (CBG) and delta-9-tetrahydrocannabinol (Δ9-THC), also exhibited significant antibacterial effects.
- CBD, CBG, and Δ9-THC showed efficacy against S. pyogenes. Synergistic effects were noted with combined cannabinoid and essential oil treatments.
Conclusions:
- Cannabinoid antibacterial potency is linked to specific structural features, particularly in CBD and its derivatives.
- These findings suggest cannabinoids hold promise as a novel therapeutic strategy against drug-resistant bacterial infections.
- Further clinical research is required to validate the therapeutic potential of cannabinoids.
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