A Systematic Review of the Philippine Plants' Antibacterial Properties against Staphylococcus aureus

Staphylococcus aureus poses a significant public health threat globally, where both community and hospital-acquired infections are prevalent. The escalating antimicrobial resistance highlights the urgent need for alternative therapies. Hence, traditional medicine using plant extracts offers a potential avenue for novel antibacterial agents. This systematic review aimed to evaluate the existing literature on the antibacterial properties of Philippine plants against S. aureus to provide focus on drug development of a plant-derived antibacterial for this pathogen.

Following PRISMA guidelines, a comprehensive search was conducted in PubMed/Medline, SCOPUS, and Herdin databases. Inclusion criteria encompassed in vitro studies evaluating the antibacterial activity of crude plant extracts sourced from Philippine plants against S. aureus. Data extraction and quality assessment were performed independently by two reviewers, with discrepancies resolved by the third and fourth reviewers.

Of the 413 initial studies identified, nine met the eligibility criteria. The highest zone of inhibition was demonstrated by Lippia micromera leaf essential oil at 26.3±1.5 mm, while moderate antibacterial activity was shown by essential oils from Alpinia elegans, Piper quinqueangulatum, and Alpinia cumingii at MIC values of 512 μg/mL, 512 μg/mL, and 1,024 μg/mL, respectively. Other Philippine plants showed a wide range of activity, with MIC values between 50 μg/mL and 25 mg/mL, MBC values from 78 to 5000 μg/mL, and ZOI ranging from 5 to 38 mm. However, the overall quality of evidence in these other studies are compromised by bias and incomplete reporting.

Leaf essential oils from Alpinia elegans, Piper quinqueangulatum, and Alpinia cumingii demonstrated moderate antibacterial activity against S. aureus. Additionally, the essential oils of Lippia micromera, Plectranthus amboinicus Lour. Spreng, and Cymbopogon citratus exhibited antibacterial activity against both S. aureus and Methicillin-resistant S. aureus (MRSA) in disk diffusion assays, these antibacterial activities may be attributed to their high concentrations of terpenes, terpenoids, and phenolic compounds. Majority of the studies gathered had high risk of bias according to the quality assessment criteria tool used in the study. Thus, this systematic review also emphasizes the need for improved methodological rigor on reporting in vitro antibacterial studies.