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  2. Volume 3 | Issue 2 [April to June]
  3. KRIMIGHNA DRAVYA AGAINST DRUG-RESISTANT BACTERIA: A CRITICAL REVIEW OF IN VITRO EVIDENCE, METHODOLOGICAL STANDARDS AND TRANSLATIONAL PROSPECTS
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Dr. Abhay Gandhi

KRIMIGHNA DRAVYA AGAINST DRUG-RESISTANT BACTERIA: A CRITICAL REVIEW OF IN VITRO EVIDENCE, METHODOLOGICAL STANDARDS AND TRANSLATIONAL PROSPECTS

Antimicrobial resistance is a global health threat, and the World Health Organization’s 2024 priority list places carbapenem-resistant Gram-negative bacteria and rifampicin-resistant Mycobacterium tuberculosis in its critical group. Ayurveda describes many drugs as krimighna, acting against krimi, a term that covers intestinal worms and other harmful organisms. These drugs are frequently tested against drug-resistant bacteria in the hope of finding new antimicrobials. This review appraises representative in vitro evidence for krimighna and related drugs, including Vidanga (Embelia ribes), Nimba (Azadirachta indica), Triphala and the Terminalia fruits, against resistant pathogens. It also considers the methodological standards such studies should meet. Reported minimum inhibitory concentrations of crude extracts against resistant isolates were mostly 50–1,500 µg/mL. Neem seed extract inhibited multidrug-resistant Salmonella Typhi at 50–500 µg/mL, and Terminalia extracts inhibited methicillin-resistant Staphylococcus aureus at 94–392 µg/mL and ESBL-producing Gram-negatives at 556–1,509 µg/mL. These values are weak by accepted criteria for natural products. A more interesting finding is synergy: Triphala lowered the MIC of gentamicin against resistant Gram-negative bacilli and of oxacillin against MRSA. Common weaknesses include non-standard methods, missing cytotoxicity and selectivity data, no consideration of achievable concentrations, and frequent ignoring of interference by tannins and other non-specific constituents. Realistic translational routes are topical and wound applications, local gut-acting uses consistent with classical krimi treatment, and antibiotic adjuvants. We propose minimum standards for future studies.