Synergistic Effect in Combination of Danshen (Salvia miltiorrhiza) Extracts with Antibiotics against Methicillin-resistant Staphylococcus aureus

Danshen (Salvia miltiorrhiza Bunge) is a traditional Korean medicine that is commonly used for the treatment of inflammatory diseases such as edema, arthritis, hepatitis, and endangitis. The several extracts of danshen were tested for antimicrobial activity against methicillin-resistant Staphylococcus aureus (MRSA) isolated in clinic by broth microdilution method, the checkerboard, and time-kill methods to evaluate the synergistic effects of the combination of the extracts with antibiotics. The chloroform ($CHCl_3$) and n-hexane (HEX) extracts [minimum inhibitory concentration (MIC), 0.0078-0.3125${\mu}g/mL$; minimum bactericidal concentration (MBC), 0.019-0.625${\mu}g/mL$] were found to have strong antibacterial activity against MRSA. Additionally, when the $CHCl_3$ and HEX extracts were co-administered with ampicillin or oxacillin, a synergistic effect against MRSA was observed. Furthermore, a time-kill study evaluating the effects of the extracts against MRSA indicated that treatment with the $CHCl_3$ extract in combination with ampicillin or oxacillin produced rapid bactericidal activity. These results suggest that danshen extracts may have potently antimicrobial activity and thus, it can be a suitable phytotherapeutic agent for treating MRSA infections.