Synergistic Antibacterial Activity of 1-Methyl Ester-Nigericin and Methyl 5-(Hydroxymethyl) Furan-2-Carboxylate Against Proteus spp.

<b>Background and Objective:</b> Synergistic combinations of antimicrobial agents with different mechanisms of action are successful approaches for combating bacterial infections. This study aimed to evaluate the synergistic effect of 1-methyl ester-nigericin <b>(1)</b> and methyl 5-(hydroxymethyl) furan-2-carboxylate <b>(2)</b> against <i>Proteus</i> spp., isolates. <b>Materials and Methods:</b> The synergistic antimicrobial activity of the compounds was tested by the checkerboard method and time-kill curves. To estimate the interaction between the compounds, the Fractional Inhibitory Concentration Index (FICI) of the combination was calculated. The cytotoxic activity of the compounds in combination was determined by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay on LLC-MK2 cell lines. The reduction percentage of biofilms was obtained using the colourimetric method. <b>Results:</b> The MIC values for compounds <b>1</b> and <b>2</b> against test bacteria ranged from 39.06-78.12 µg mL¹ and from 78.12-156.25 µg mL¹, respectively. The MIC was reduced to 1-8th as a result of the combination of compounds <b>1</b> and <b>2</b>. After 4-24 hrs of treatment with ½ MIC of compounds <b>1</b> and <b>2</b>, the killing rate (in CFU mL¹) increased to a greater degree than observed with either test compound alone. The combination of compounds <b>1</b> and <b>2</b> showed a synergistic effect with FICI of 0.50 and 0.28. The synergistic combination of compounds <b>1</b> and <b>2</b> was effective on the biofilm reduction of <i>Proteus</i> <i>vulgaris</i> NP16 (85.72%) and NP47 (89.14%). <b>Conclusion:</b> This study recommends compounds <b>1</b> and <b>2</b> in combination as a potential alternative treatment agent for <i>Proteus</i> spp. infections.