Antibiofilm activity of Kashaya Upakrama (Shasti Upakrama): An exploratory study on common wound isolates

Wound healing is a significant concern for uneventful healing in surgery. Vrana and its chikitsa have received considerable attention from Acharya Sushruta. In Shashti upakramas, he described various formulations of Vrana Shodhana and Vrana Ropana. Many antiseptic treatments that prevent infection are employed extensively in modern research, however they do not speed up the healing process and are cytotoxic and detrimental to wound healing. Complex microbial communities known as biofilms are encased in a self-produced biopolymer matrix that offers defence against host defence mechanisms and antimicrobial agents. The development of a preparation with antibacterial, anti-inflammatory, and anti-biofilm capabilities is required. Biofilms play a significant role in delayed wound healing, and in order to advance the evidence-based practice of Shasti upakrama with reference to Kashaya Upakrama, biofilm experimental studies that are clinically relevant are required. Methods: The bacterial strains of P. aeruginosa, E. coli, and S. aureus was maintained in laboratory using appropriate media and following the standard protocols up to completion of the study. Following the Kugaji et al.22 methodology, the bacterial composing biofilm was cultivated. Using fluorescence microscopy, the exopolysaccharide and morphology of the multi-species biofilm structure were further examined. Results: MIC values in this investigation were 6.25-12.5µg/ml. Pentabark Kashaya’s MBC values against the strains varied between 25-6.25µg/ml. Both MIC and MBC concentrations showed time-dependent suppression of bacterial growth, with a sharp decline within 10 hours. According to the biofilm reduction experiment,Pentabark Kashaya’s concentrations considerably decreased the proportion of attached microbes, reaching 63.5%-53.3%. This was further supported by fluorescence microscopy. Conclusion: Pentabark kashaya – Ayurvedic Herbo-Mineral Formulations has shown anti-bacterial activities in both concentration inhibition by MIC and MBC, time inhibition by time kill assay. Pentabark kashaya has shown significant antibiofilm activity on commonly found wound pathogens S. aureus, P. aeruginosa and E. coli and confirmed by fluorescence assay.