The Future Potential of Medicinal Plants from the Middle East in Combating Antibiotic Resistance

Abstract

Antibiotic resistance has escalated into a global health crisis, creating an urgent need for new antimicrobial strategies as the pipeline of conventional antibiotics dries up. In this context, medicinal plants—especially those from the Middle East with its rich biodiversity and deep ethnomedical traditions—represent an untapped reservoir of novel antibacterial agents and resistance-modifying compounds. This review provides a comprehensive analysis of how Middle Eastern medicinal plants could help combat antibiotic-resistant bacteria. We first outline the major mechanisms of bacterial resistance, including enzymatic drug inactivation, target modification, efflux pump activity, and biofilm formation, which jointly render many pathogens impervious to current antibiotics. We then highlight the extraordinary diversity of medicinal flora in the Middle East and its history of use against infections, underlining that hundreds of regional plant species (e.g. Allium sativum, Nigella sativa, Thymus vulgaris) exhibit significant antimicrobial properties in traditional practice. Selected case studies of these three emblematic plants are presented, summarizing their bioactive constituents (such as allicin, thymoquinone, thymol) and demonstrated activities against drug-resistant pathogens. We further discuss evidence of synergistic effects between plant-derived compounds and conventional antibiotics – for example, plant phenolics acting as efflux pump inhibitors or biofilm disruptors can restore antibiotic efficacy. Despite the promise, important limitations and scientific gaps remain, including variability in phytochemical content, insufficient clinical trials, and challenges in standardization and safety regulation. Addressing these gaps through robust research and supportive policies is critical. Finally, we recommend a coordinated strategy for future research and policy, advocating for interdisciplinary collaborations to isolate novel phytochemicals, evaluate their pharmacodynamics and pharmacokinetics, and integrate proven plant-based remedies into mainstream antibiotic stewardship. Harnessing Middle Eastern medicinal plants could provide affordable, effective complementary therapies and lead compounds for drug development, thus offering a much-needed boost in the fight against antibiotic-resistant infections.

Keywords: antibiotic resistance, medicinal plants, Middle East, herbal antimicrobials, synergy, Allium sativum, Nigella sativa, Thymus vulgaris, efflux pump inhibitors, phytochemicals

DOI: 10.7176/JBAH/15-2-02

Publication date: July 30th 2025