Synergistic and Additive Effects of Menadione in Combination with Antibiotics on Multidrug-Resistant Staphylococcus aureus: Insights from Structure-Function Analysis of Naphthoquinones

ChemMedChem. 2023 Dec 14;18(24):e202300328. doi: 10.1002/cmdc.202300328. Epub 2023 Nov 10.

Abstract

Antimicrobial resistance (AMR) interferes with the effective treatment of infections and increases the risk of microbial spread and infection-related illness and death. The synergistic activities of combinations of antimicrobial compounds offer satisfactory approaches to some extent. Structurally diverse naphthoquinones (NQs) including menadione (-CH3 group at C2) exhibit substantial antimicrobial activities against multidrug-resistant (MDR) pathogens. We explored the combinations of menadione with antibiotic ciprofloxacin or ampicillin against Staphylococcus aureus and its biofilms. We found an additive (0.5<FICI ${ \le }$ 1.0) and synergistic (FICI≤0.5) effect of menadione with ciprofloxacin and ampicillin, respectively. High reactive oxygen species (ROS) activity and inhibition of biofilm formation (>90 %) were also observed. However, preformed biofilms were not affected. Dent formation was also evident in S. aureus treated with the test compounds. The structure-function relationship (SFR) of NQs was used to determine and predict their activity pattern against pathogens. Analysis of 10 structurally distinct NQs revealed that the compounds with -Cl, -Br, -CH3 , or -OH groups displayed the lowest MICs (32-256 μg/mL). Furthermore, 1,4-NQs possessing a halogen or -CH3 moiety showed elevated ROS activity, whereas molecules with an -OH group affected cell integrity. Improved activity of antimicrobial combinations and SFR approaches are significant in antimicrobial therapies.

Keywords: Antimicrobial resistance; menadione; naphthoquinones; reactive oxygen species; structure-function relationships.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ampicillin / pharmacology
  • Anti-Bacterial Agents / pharmacology
  • Biofilms
  • Ciprofloxacin / pharmacology
  • Humans
  • Methicillin-Resistant Staphylococcus aureus*
  • Microbial Sensitivity Tests
  • Naphthoquinones* / pharmacology
  • Reactive Oxygen Species
  • Staphylococcal Infections*
  • Staphylococcus aureus
  • Vitamin K 3 / pharmacology

Substances

  • Anti-Bacterial Agents
  • Vitamin K 3
  • Naphthoquinones
  • Reactive Oxygen Species
  • Ampicillin
  • Ciprofloxacin