Synergistic effect of (Azadirachta indica) Neem extract on multi drug-resistant gram-negative isolates from clinical samples at a tertiary care center

The indiscriminate usage of antibiotics in treatment and animal feed has led to the development of pan and multi drug resistance. The developing resistance in addition to the mortality had skewed the minds of researchers in search of newer antimicrobial agents. Among the native plants, one with potent antibacterial activity is Neem (Azadirachta indica). The leaves, bark, flowers, fruits, seed, and gum of the neem tree are utilised for various beneficial effects. The clinical samples including pus, urine, aspirate, sputum was sent to the microbiology department. The Gram negative Multi drug resistant organisms were included in the study. Around 210 isolates were obtained during the study period out of which 66 (31.4%) isolates were MDR. The synergistic effect of Neem extract was evaluated which showed a significant change in the susceptibility as intermediate range to susceptible range, resistant to intermediate and resistant to sensitive. The Neem extract has better antibacterial effect however, multicentric studies must be carried out to identify the minimum inhibitory concentration against various isolates.