An effective antimicrobial strategy of colistin combined with the Chinese herbal medicine shikonin against colistin-resistant <i>Escherichia coli</i>

Abstract

Infections caused by multidrug-resistant <i>Escherichia coli</i> (MDR <i>E. coli</i>) have become a major global healthcare problem due to the lack of effective antibiotics today. The emergence of colistin-resistant <i>E. coli</i> strains makes the situation even worse. Therefore, new antimicrobial strategies are urgently needed to combat colistin-resistant <i>E. coli</i>. Combining traditional antibiotics with non-antibacterial drugs has proved to be an effective approach of combating MDR bacteria. This study investigated the combination of colistin and shikonin, a Chinese herbal medicine, against colistin-resistant <i>E. coli</i>. This combination showed good synergistic antibacterial both <i>in vivo</i> and <i>in vitro</i> experiments. Under the background of daily increasing colistin resistance in <i>E. coli</i>, this research points to an effective antimicrobial strategy of using colistin and shikonin in combination against colistin-resistant <i>E. coli</i>.