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TABLE 3.1 (Continued)
Botanical
taxon
Part(s)
used
Preparation and/or
administration
Treated disease(s) or folk
medical uses(s) Reference/Sources
Leaves Decoction after cooled
applied in ear
Earache and ear infections
Mustafa et al. (2012)
Extracted with fat (cow or
pig fat)—topically applied
Wound healing Mustafa et al. (2015), Pieroni
et al. (2015)
Sisymbrium
officinale (L.)
Scop.
Stems,
leaves,
fruits
Tea Respiratory system
problems (mostly to protect
from tuberculosis)
Rexhepi et al. (2013)
Solanum
tuberosum L.
Bulb Topically applied External ulcers
ˇ
Sari
´
c-Kundali
´
c et al. (2011)
Externally applied (in
slices)
Eye inflammations Pieroni et al. (2014)
Stachys
officinalis (L.)
Trevis.
Whole
plant
Tea Skin complaints (wounds,
burns), for bronchitis,
cough, asthma (tea)
ˇ
Sari
´
c-Kundali
´
c et al. (2011)
Leaves Fresh leaves are topically
applied
Skin infection Mustafa et al. (2012)
Two to three drops applied
in the ear
Earache Mustafa et al. (2012)
Infusion, topically applied Wounds Mustafa et al. (2012)
Symphytum
officinale L.
Leaves Mixed with pork fat
(poultice)
Wounds Pieroni et al. (2011)
Tanacetum
balsamita L.
Aerial
parts
Mixed with wax, incense,
pot marigold, and resin, in
a poultice (mehlem)
Every skin disease Pieroni et al. (2011)
Taraxacum
officinale (L.)
eber ex F.H.
Wigg.
Flowers Tea Urinary system
inflammations and
respiratory inflammation
Mustafa et al. (2012),
Mustafa et al. (2020)
Topically applied Wounds Pieroni et al. (2011)
Decoction mixed with
lemon fruits
Bronchitis Mustafa et al. (2012)
“Honey”: 150 flowers are
covered with 3 L water,
sugar is added and this is
cooked, one teaspoon
before a meal
Bronchitis
Jari
´
c et al. (2015)
Leaves Compress Eczema, acne, and wounds
ˇ
Savikin et al. (2013)
Teucrium
chamaedrys L.
Flowering
aerial
parts
Tea Respiratory inflammation Mustafa et al. (2012)
(Continued)
124 3. Medicinal plants in the Balkans with antimicrobial properties
Medicinal Plants as Anti-infectives
TABLE 3.1 (Continued)
Botanical
taxon
Part(s)
used
Preparation and/or
administration
Treated disease(s) or folk
medical uses(s) Reference/Sources
Teucrium
montanum L.
Leaves Tea (topically applied) Skin problems
Mustafa et al. (2020)
Teucrium
polium L.
Aerial
parts
Mixed with fat Tuberculosis, “Saraxha”
(cutaneous tuberculosis)
Mustafa et al. (2015)
Thymus
serpyllum L.
Aerial
parts
Infusion Respiratory inflammations
(bronchitis)
Hajdari et al. (2018),
Mustafa et al. (2012),
Mustafa et al. (2012),
Mustafa et al. (2015),
Mustafa et al. (2020),
Rexhepi et al. (2013)
Decoction Respiratory inflammations Mustafa et al. (2012)
Tilia cordata
Mill.
Flowers Tea Respiratory inflammations
(bronchitis)
Jari
´
c et al. (2007), Mustafa
et al. (2012)
, Mustafa et al.
(2015)
, Pieroni et al. (2005),
Pieroni et al. (2017), Rexhepi
et al. (2013)
,
ˇ
Savikin et al.
(2013)
, Zlatkovi
´
c et al. (2014)
Colds and sore throats Mustafa et al. (2015)
Decoction Sore throat, lung
inflammations
Mustafa et al. (2015)
Tilia
platyphyllos
Scop.
Flowers Tea Bronchitis, flu Mustafa et al. (2012),
Mustafa et al. (2020)
Decoction Sore throat, lung
inflammations
Mustafa et al. (2012)
Trifolium
pratense L.
Flowers Infusion Oral cavity antiseptic Mustafa et al. (2012)
Triticum
vulgare Vill.
Flour Mixed with hot water—
topically used
Skin inflammation and
ulcers
Mustafa et al. (2015)
Tussilago
farfara L.
Leaves,
flowers
Tea Ulcers Rexhepi et al. (2013)
Wounds are to be bandaged
with fresh leaf
Festering wounds and ulcers Jari
´
c et al. (2007)
Ulmus minor
Mill.
Leaves Extracted with fat Antimycotic, antibacterial,
“Saraxha” (cutaneous
tuberculosis)
Mustafa et al. (2015)
Bark Decoction, externally
applied
Wounds, burns Pieroni et al. (2015)
(Continued)
125Medicinal plants with antimicrobial properties
Medicinal Plants as Anti-infectives
TABLE 3.1 (Continued)
Botanical
taxon
Part(s)
used
Preparation and/or
administration
Treated disease(s) or folk
medical uses(s) Reference/Sources
Urtica
dioica L.
Aerial
parts
Infusion Bronchitis, antibacterial,
urinary disorders
Mustafa et al. (2015)
Tea Urinary tract infections Hajdari et al. (2018)
Tea used to wash and treat
hands and feet
Fungal skin infection Hajdari et al. (2018)
Leaves Externally applied Skin complaints, neuralgia,
hemorrhoids, hair problems
Menkovi
´
c et al. (2011)
Vaccinium
myrtillus L.
Fruits Also eaten as dried fruit Sore throats, digestive
troubles
Pieroni (2008)
Fruits,
leaves
Juice of fresh fruits Digestive tract infections,
eye inflammations, urinary
disorders
Mustafa et al. (2015)
Tea Urinary tract infections Jari
´
c et al. (2015)
Inflammation of the mouth
and throat.
Menkovi
´
c et al. (2011)
Tea, syrup (gargle as a
throat wash)
Viral infection Rexhepi et al. (2013)
Externally applied Skin rash, inflamed ulcers
ˇ
Sari
´
c-Kundali
´
c et al. (2011)
Vaccinium
vitis-idaea L.
Leaves Infusion Urinary inflammations Mustafa et al. (2015)
Fruits Infusion Urinary tract infections Mustafa et al. (2015),
ˇ
Savikin
et al. (2013)
Fruits and
leaves
Infusion Wound healing Mustafa et al. (2015)
Areal
parts
Respiratory ailments,
influenza, nipple
inflammation during
lactation
ˇ
Sari
´
c-Kundali
´
c et al. (2011)
Tea and fresh fruit as part
of a person’s diet
Urinary tract infections Jari
´
c et al. (2015)
Valeriana
officinalis L.
Leaves Macerated leaves are mixed
with yogurt and topically
applied
Breast inflammations
Mustafa et al. (2012)
Verbascum
phlomoides L.
Flowers Tea Antiseptic properties,
respiratory ailments
(bronchitis, laryngitis,
asthma, influenza,
tuberculosis)
Jari
´
c et al. (2007), Rexhepi
et al. (2013)
(Continued)
126 3. Medicinal plants in the Balkans with antimicrobial properties
Medicinal Plants as Anti-infectives
Apiaceae
Petroselinum crispum (Mill.) Fuss
Petroselinum crispum (Mill.) Fuss (parsley) is an herb native to the Mediterranean region.
The aerial parts of P. crispum showed antibacterial activity against several Vibrio
spp. strains with MIC values ranging from 19 to 39 μg/mL (
Snoussi et al., 2016). A recent
clinical trial tested the efficacy of using P. crispum powder as an herb-based antimicrobial
treatment for urinary tract infections (UTIs). With a sample size of 37 patients with UTIs,
patients indicated a significant decline in indicators such as frequency, dysuria, suprapu-
bic pain, and loin pain upon completion of the study. Furthermore, the general urine
exam saw a significant decrease in terms of acidity, pus cells, crystals, and epithelial cells
(
Nashtar & Al-Attar, 2018). In vitro studies similarly demonstrated strong antibacterial
activity of P. crispum against UTI clinical isolates (
Petrolini et al., 2013). Studies such as
these show promising results for the use of parsley as an antimicrobial agent against
human urinary infections.
Asteraceae
Achillea millefolium L.
Achillea millefolium L. (yarrow) is a flowering plant native to eastern Turkey. Ethanolic
extracts of A. millefolium exhibit high antibacterial activity against Bacillus cereus
(MIC 5 0.85 μg/mL), Enterococcus faecalis (MIC 5 1.71 μg/mL), Serratia rubidaea
(MIC 5 1.19 μg/mL), Escherichia coli (MIC 5 13.59 μg/mL), Lactobacillus brevis
(MIC 5 0.85 μg/mL), and Lactobacillus hilgardii (MIC 5 0.59 μg/mL). Constituents such as
terpinolene, 1,8-cineole, thujone, camphor, and borneol may be responsible for the antibac-
terial activity of A. millefolium (
Ali et al., 2017). Although some clinical trials investigate
the efficacy of A. millefolium as a pain reliever, antiinflammatory agent, and wound healing
aid, further clinical studies must be conducted to test the antibacterial potential of the spe-
cies (
Hajhashemi et al., 2018; Jenabi & Fereidoony, 2015).
TABLE 3.1 (Continued)
Botanical
taxon
Part(s)
used
Preparation and/or
administration
Treated disease(s) or folk
medical uses(s) Reference/Sources
Veronica
officinalis L.
Leaves Infusion Respiratory system
inflammations, wound
healing
Mustafa et al. (2015)
Aerial
parts
Externally applied Skin diseases, wounds Menkovi
´
c et al. (2011)
Vitis
labrusca L.
Young
shoots
Squeezed to extract juice
that is topically applied to
wounds
Antiseptic Pieroni et al. (2014)
Zea mays L. Fruits Infusion Urinary tract inflammations Mustafa et al. (2015)
127Medicinal plants with antimicrobial properties
Medicinal Plants as Anti-infectives
Artemisia absinthium L.
Artemisia absinthium L. (wormwood) is a flowering plant with origins in eastern Turkey.
The chloroform extract from the leaves of A. absinthium exhibited MIC values ranging from
128 to 256 μg/mL against Staphylococcus aureus, Enterococcus faecalis,andBacillus cereus
(
Fiamegos et al., 2011). The compounds thujone, linalool, and β-caryophyllene are associated
with the antibacterial activity found in A. absinthium. An in vivo study analyzing surgical
rat wounds infected with Staphylococcus aureus showed a significant reduction in bacterial
count at the wound site upon topical application of A. absinthium (
Moslemi et al., 2012).
Calendula officinalis L.
Calendula officinalis L. (pot marigold) is an annual herbaceous plant found throughout Europe.
Leaves and flowers of C. officinalis extracted with methanol had MICs against several Gram-
positive and Gram-negative bacteria, including Staphylococcus epidermidis (MIC 5 10 μg/mL),
Listeria monocytogenes (MIC 5 15 μg/mL), Bacillus megaterium (MIC 5 35 μg/mL), Escherichia
coli (MIC 5 35 μg/mL), and Shigella flexneri (MIC 5 50 μg/mL) (
Szakiel et al., 2008). Major
flavonoid-based components such as rutin, gallic acid, and quercetin-3-O-glucoside may be
responsible for the antibacterial activity of the methanolic flower extracts (
Rigane et al., 2013).
Furthermore, the antibacterial activity of the essential oil of C. officinalis shown in other studies
may be a result of its major chemical constituents, including citral, geraniol, eugenol, menthol,
and cinnamic aldehyde (
Chaleshtori et al., 2016). A clinical trial conducted on 18 patients
assessed the efficacy of a mouthwash containing C. officinalis agains t microorganisms adhering
to sutures upon molar extraction. The treatment group saw a reduction in microorganism
count compared to baseline, thus suggesting that C. officinalis showed antibacterial activity
against microorganisms adhering to dental sutures (
Faria et al., 2011).
Matricaria chamomilla L.
Matricaria chamomilla L. (chamomile) is an annual herb native to Europe and Western Asia.
Essential oils showed inhibitory activity with MIC values ranging from 0.011 to 4 μg/mL
against Staphylococcus aureus, Bacillus cereus, Bacillus subtilis, Shigella shiga, Shigella sonnei,and
Pseudomonas aeruginosa (
Kazemi, 2015). Ethanolic and methanolic extracts also showed MICs
of 12.515 μg/mL against Escherichia coli, Bacillus cereus, Staphylococcus aureus,andSalmonella
typhi (
Roby et al., 2013). Compounds isolated from the essential oil, such as bisabolol, bisabo-
lol oxide, limonene, camphene, and camphor demonstrate high antibacterial activity and may
be responsible for the antimicrobial properties seen in M. chamomilla (
Kazemi, 2015). For more
information on the antibacterial properties and clinical trials conducted with M. chamomilla,
refer to a comprehensive literature review (
Chassagne et al., 2021).
Betulaceae
Alnus glutinosa (L.) Gaertn.
Alnus glutinosa (L.) Gaertn. (black alder) is a tree species found throughout Europe,
southwest Asia, and northern Africa. The ethanolic and metha nolic extracts from the
leaves of A. glutinosa showed antibacterial against Staphylococcus aureus, Bacillus subtilis,
Escherichia coli, Klebsiella aerogenes, and Pseudomonas aeruginosa with MIC values ranging
128 3. Medicinal plants in the Balkans with antimicrobial properties
Medicinal Plants as Anti-infectives
from 125 to 250 μg/mL (Altinyay et al., 2015; Middleton et al., 2010). The compound
oregonin produced from the methanolic extract of A. glutinosa shows extremely high anti-
bacterial properties against both Gram-negative and Gram-positive bacteria (Bacillus
subtilis—15.6 μg/mL, Staphylococcus aureus—15.6 μg/mL, Proteus vulgaris—31.2 μg/mL)
and may be responsible for the antibacterial effects seen in A. glutinosa (
Abedini et al.,
2016
). The flavonoid, genkwanin, also extracted from the methanol, may also be responsi-
ble for some antibacterial activity, with an MIC value of 0.5 μg/mL against Bacillus cereus
(
Kumarasamy et al., 2006).
Lamiaceae
Lavandula angustifolia Mill.
Lavandula angustifolia Mill. (lavender) is a flowering plant native to the Mediterranean
region. Its essential oil has strong antibacterial activities against Escherichia coli,
Pseudomonas aeruginosa, Proteus mirabilis, Klebsiella pneumoniae, Acinetobacter baumannii,
Staphylococcus aureus, Enterococcus faecalis, and Bacillus subtilis with MIC values ranging
from 2 to 8 μg/mL (
Erdog an Orhan et al., 2012). Hydroxycinnamic acids such as rosmari-
nic acid, chlorogenic acid, and caffeic acid, as well as flavonoids like rutin and quercetin
are a few of the constituents primarily responsible for the antibacterial activity of L. angu-
stifolia (
Zena
˜
o et al., 2017). An in vivo study was conducted to assess the effect of the topi-
cal antibacterial treatment of L. angustifolia and Thymus vulgaris against bovine
staphylococcal and streptococcal mastitis. The results indicated that intramammary appli-
cation of a solution of Lavandula angustifolia and Thymus vulgaris significantly decreased
the bacterial count of staphylococci and streptococci in the milk produced by the cows in
the study (
Abboud et al., 2015).
Mentha longifolia (L.) L.
Mentha longifolia (L.) L. (wild mint) is an herbaceous perennial found in Europe, western
and central Asia, and parts of Africa. The essential oil of M. longifolia showed antibacterial
activity with MIC’s ranging from 15.62 to 62.50 μg/mL against Bacillus macerans,
Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Bacillus subtilis, and
Enterococcus faecalis (
Gulluce et al., 2007). Flavonoids such as quercetin-3-O-glycoside and
terpenoids such as menthol isolated from the leaves of M. longifolia may be responsible for
the antibacterial activity demonstrated (
Al-Bayati, 2009). Furthermore, active constituents
in the essential oil of M. longifolia, such as cis-piperitone epoxide, piperitenone oxide, pule-
gone, and menthone, also contribute greatly to the antibacterial activity of the essential oil.
Mentha x piperita L.
Mentha x piperita L. (peppermint) is a hybrid cross between Mentha spicata (spearmint) and
Mentha aquatica L. (watermint) and is a small herbaceous species native to the Mediterranean
region. The essential oil showed antibacterial activity against Streptococcus pneumonia,
Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Salmonella typhi, Listeria
monocytogenes,andKlebsiella pneumoniae with MIC values ranging from 0.5 to 8 μg/mL
129Medicinal plants with antimicrobial properties
Medicinal Plants as Anti-infectives
(Abolfazl et al., 2014). Further information about Mentha x piperita can be found in a prior
review by our group (
Chassagne et al., 2021).
Ocimum basilicum L.
Ocimum basilicum L. (basil) is an herb found in subtropical regions of Asia, Africa, and
South America. O. basilicum showed antibacterial activity against several Vibrio spp. strains
with MIC values ranging from 19 to 39 μg/mL (
Snoussi et al., 2016). Methanol extracts from
the leaves of O. basilicum also exhibited MICs ranging from 62.5 to 125 μg/mL against
Bacillus cereus, Bacillus megaterium, Staphylococcus. aureus, Bacillus subtilis, Listeria monocyto-
genes,andEscherichia coli (
Hossain et al., 2010). Chemical constituents such as rosmarinic
acid may be responsible for the antibacterial activity seen in the essential oils of O. basilicum
(
Bais et al., 2002).
Origanum vulgare L.
Origanum vulgare L. (oregano) is an aromatic perennial herb found in the Mediterranean
region. Coccimiglio et al. reported that the ethanolic extract showed MIC values ranging
from 6.3 to 12.5 μg/mL against Pseudomonas aeruginosa, Escherichia coli, Bordetella bronchisep-
tica, Burkholderia cenocepacia, Acinetobacter baumannii, and Bacillus subtilis (
Coccimiglio et al.,
2016
). The essential oils show the highest antibacterial activity, with MIC’s ranging from
0.3 to 100 μg/mL (
Helal et al., 2019; Santos et al., 2017). For a more comprehensive review
of Origanum vulgare, refer to previous work by our group (
Chassagne et al., 2021).
Malvaceae
Althaea officinalis L.
Althaea officinalis L. (marshmallow) is a perennial species native to Europe, Western
Asia, and Northern Africa. The methanolic extract has antibacterial activity against Bacillus
psychrosaccharolyticus (MIC 5 31.25 μg/mL), Exiguobacterium acetylicum (MIC 5 125 μg/mL),
Escherichia coli (MIC 5 31.25 μg/mL, Staphylococcus aureus (MIC 5 15.63 μg/mL), and
Pseudomonas aeruginosa (MIC 5 62.5 μg/mL) (
Mehreen et al., 2016; Ozturk & Ercisli, 2007).
A rat model in vivo study assessed the wound healing properties of Althaea officinalis. The
flavonoids in A. officinalis may be responsible for the antibacterial activity exhibited,
through further phytochemical studies must be conducted to assess the specific com-
pounds and their inhibitory activity (
Mehreen et al., 2016). The topically administered
hydroethanolic extract was found to significantly reduce the wound size compared to the
control, and the results of the in vitro analyses demonstrated the antibacterial properties
of A. officinalis against several Gram-positive bacteria (
Rezaei et al., 2015).
Malva sylvestris L.
Malva sylvestris L. (common mallow) is an annual plant native to regions in Europe,
Northern Africa, and Southwest Asia. Methanolic extracts from the leaves of M. sylvestris
exhibited antibacterial activity against Staphylococcus aureus, Enterococcus faecalis, Streptococcus
agalactiae,andErwinia carotovora with MICs ranging from 35 to 37 μg/mL, and the flowers
showed activity against Escherichia coli with a MIC of 31 μg/mL (
Razavi et al., 2011).
130 3. Medicinal plants in the Balkans with antimicrobial properties
Medicinal Plants as Anti-infectives
Although specific chemical constituents in methanolic extracts of M. sylvestris have not been
identified to explain its antibacterial activity against the listed microbes, the major constitu-
ent of the oil, eugenol, was shown to exhibit inhibitory activity (
Cecotti et al., 2016).
Furthermore, the phytoalexin, malvone A (2-methyl-3-methoxy-5,6-dihydroxy-1,4-naphtho-
quinone), showed inhibitory activity against the pathogen Verticillium dahliae (
Veshkurova
et al., 2006
). The mechanism behind this important antibacterial agent may provide insight
into future research on the pharmacology of M. sylvestris. Two different in vivo studies con-
ducted on Wistar rats exhibited both the wound healing and burn healing potential of the
diethyl ester extract of Malva sylvestris,withtheM. sylvestris-treated group showing a signifi-
cant reduction in wound size and burn size compared to the control groups (
Pirbalouti
et al., 2009; Pirbalouti et al., 2010
).
Pinaceae
Larix decidua Mill.
Larix decidua Mill. (European larch) is a deciduous conifer found in the Alps, the Sudetes,
and the Carpathian mountains. Methanolic extracts from the bark showed antibacterial
activity against Listeria monocytogenes, Bacillus cereus, Staphylococcus aureus, Dickeya solani,
Pectobacterium atrospecticum,andMicrococcus flavus with MIC values ranging from 150 to
220 μg/mL (
Salem et al., 2016). Compounds such as abietic acid, oleanolic acid, larixol, 2,9-
dihydroxyverrucosane, nonacosane are responsible for the antibacterial properties of the
methanolic extract of L. decidua (
Salem et al., 2016). Animal studies must be conducted to
assess the in vivo efficacy of this plant species as an antibacterial agent.
Picea abies (L.) H.Karst.
Picea abies (L.) H.Karst. (Norway spruce) is the most common conifer in Europe and is
native to regions spanning from Scandinavia to Northern Russia. Methanolic extracts from
the wood and bark showed antibacterial activity against Escherichia coli (MIC 5 60 μg/mL),
Staphylococcus aureus (MIC 5 130 μg/mL), Listeria monocytogenes (160 μg/mL), and Bacillus
cereus (MIC 5 140 μg/mL) (
Salem et al., 2016). Several constituents of P. abies are responsi-
ble for its antibacterial activity including the piperidine alkaloid, epidihydropinidine, as
well as flavonols like kaempferol, quercetin, and myricetin, and stilbene glucosides such
as piceid (
Fyhrquist et al., 2018; Metsa
¨
muuronen & Sire
´
n, 2019). Resin salve extracted from
P. abies was used in a pilot clinical trial to assess its effectiveness in surgical wound heal-
ing. The trial included 23 patients whose wound healing postsurgery was delayed. The
resin salve treatment group saw a significant reduction in wound size and an improved
healing time compared to the control, despite the presence of microbes at the infection site
(
Sipponen et al., 2012).
Rosaceae
Agrimonia eupatoria L.
Agrimonia eupatoria L. (agrimony) is a perennial herb native to Europe and Southwest
Asia. The acetone extract from the aerial parts showed antibacterial activity with MIC
131Medicinal plants with antimicrobial properties
Medicinal Plants as Anti-infectives
values ranging from 120 to 310 μg/mL against Staphylococcus aureus, Bacillus subtilis,
Bacillus cereus, Lactobacillus rhamnosus, and Bifidobacterium animalis subsp. lactis (
Muruzovi
´
c
et al., 2016
). An ointment prepared from the ethanolic extract of A. eupatoria was shown to
have significant wound healing properties in rats, with the ethanolic extract exhibiting fas-
ter wound healing times compared to the control group. The researchers concluded that
A. euphoria tannin and flavonoid constituents contributed to the observed accelerated
wound healing process due to their antibacterial properties (
Ghaima, 2013).
Prunus spinosa L.
Prunus spinosa L. (blackthorn) is a flowering plant native to Europe, western Asia, and
northwest Africa. The methanolic extract from the fruits of P. spinosa showed MIC against
Staphylococcus aureus (MIC 5 7.8 μg/mL), Citrobacter freundii (MIC 5 31.25 μg/mL), Listeria
innocua (MIC 5 31.2 μg/mL), and Sarcina lutea (62.5 μg/mL) (
Kumarasamy et al., 2004;
Radovanovi
´
c et al., 2013
).
Rosa canina L.
Rosa canina L. (dog rose) is a deciduous shrub native to Europe, western Asia, and north-
west Africa. A geometric isometric mixture (2:1) extracted with methanol from the seeds of R.
canina exhibited high antibacterial activity against Lactobacillus plantarum (MIC 5 0.1 μg/mL),
Staphylococcus epidermidis (0.1 μg/mL), and Proteus mirabilis (10 μg/mL). The compounds
responsible for such antibacterial properties were identified as the flavonoid glycoside
isomers, kaempferol 3-O-(6v-O-E-p-coumaroyl)-β-
D-glucopyranoside and kaempferol 3-O-
(6v-O-Z-p-coumaroyl)-β-
D-glucopyranoside (Kumarasamy et al., 2003). A triple-blind random-
ized clinical trial was conducted to assess the effect of the fruits of R. canina in preventing
UTIs in women following a cesarean section. The results showed that the incidence of UTI
was significantly lower in the group that received 500 mg of R. canina compared to the pla-
cebo group. Because UTIs are characterized by inflammation due to bacterial invasion, it can
be concluded that the antibacterial activity exhibited in R. canina may be partially responsible
for the results of this clinical trial (
Seifi et al., 2018).
Rubus fruticosus L.
Rubus fruticosus L. (blackberry) is a peren nial shrub native to regions throughout
Europe. The methanolic extract from the stem of R. fruticosus showed an inhibitory concen-
tration of 20 μg/mL against Escherichia coli, Salmonella typhi, Staphylococcus aureus, Proteus
mirabilis, Micrococcus luteus, Bacillus subtilis, and Pseudomonas aeruginosa (
Riaz et al., 2011).
Urticaceae
Urtica dioica L.
Urtica dioica L. (nettle) is a perennial flowering plant native to Europe, temperate Asia,
western North Africa but cultivated throughout the world. The hexane extract showed
inhibitory activity against Salmonella typhi, Escherichia coli, Klebsiella pneumoniae,
Staphylococcus aureus, Enterococcus faecalis, Shigella flexneri, and Pseudomonas aeruginosa with
MIC values ranging from 7.81 to 250 μg/mL. Constituents isolated from the hexane
132 3. Medicinal plants in the Balkans with antimicrobial properties
Medicinal Plants as Anti-infectives
extracts, such as neophytadiene, heptadecyl ester, hexyl octyl ester, butyl tetradecyl ester,
and 1,2 benzenedicarboxylic acid, may be responsible for the antibacterial activity exhib-
ited in U. dioica (
Dar et al., 2013). The wound-healing potential of hydroethanolic extract
from the leaves of U. dioica was assessed in a rat model in vivo study. The topical treat-
ment of U. dioica on the surgical wound showed faster healing rates compared to the
control group. An in vitro quantification of the inhibitory potential of U. dioica in this
study showed strong antibacterial activity against Pseudomonas aeruginosa and Enterococcus
faecalis, two microorganisms commonly associated with open wounds (
Zouari Bouassida
et al., 2017
).
Conclusions
The Balkan region contains a reservoir of TEK, which serves as a predominant form of
healthcare especially in isolated mountainous and rural areas where access to Western
medicine is limited. The geographic isolation, rich biodiversity, and complex biocultural
variety have shaped specific knowledge on the traditional uses of botanical species to treat
infectious diseases. Thus, TEK applications in regions can be used not only to preserve
cultural traditions and local natural resources but also for drug discove ry initiatives and
public health issues, as not all-natural remedies are safe.
The Balkans also possess a wealth of diverse antibacterial species that may show prom-
ising clinical applications for bacterial diseases. Of the species described herein, Allium
sativum, Achillea millefolium, Calendula officinalis, Matricaria chamomilla, Origanum vulgare,
Lavandula angustifolia, Mentha x piperita, Malva sylvestris, Rosa canina, and Urtica dioica
showed the most potent antibacterial activity, with MICs # 100 μg/mL against a range of
microorganisms. Several of these species, including A. sativum, M. chamomilla, Mentha
x piperita, O. vulgare, M. sylvestris, and U. dioica exhibited wound or burn healing activity
in vivo. However, the safety of these extracts needs to be studied more in depth prior to
their use in human clinical trials. Despite this limitation, some pilot human-based clinical
trials have been conducted to test species such as C. officinalis and M. chamomilla for their
wound-healing potential against oral pathogens, as well as R. canina against UTIs. Future
research should focus on conducting more in vivo studies and human clinical trials that
highlight and explain the diverse antibacterial properties of the above Balkan species, as
well as those listed in
Table 3.1.
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Medicinal Plants as Anti-infectives