The Potential of Medicinal Plants as an Alternative Therapy for Bacterial Pharyngitis Caused by Streptococcus pyogenes: A Literature Review
DOI:
https://doi.org/10.53366/jimki.v12i2.829Keywords:
Bacterial Pharyngitis, Medicinal Plants, Minimum Inhibitory ConcentrationAbstract
Abstract
Introduction: Pharyngitis is an inflaccccccmmation of the pharynx commonly occurring in children to adults, with over 10 million outpatient visits annually and 50% of cases occurring in individuals aged 5 to 24 years. It can be caused by viral or bacterial infections, with Streptococcus pyogenes being the most common bacterial cause. Although antibiotics remain the primary treatment for bacterial pharyngitis, the increasing prevalence of antimicrobial resistance highlights the need for alternative therapies based on medicinal plants. This literature review aims to summarize various global studies on plant extracts to explore their potential as alternative therapies for pharyngitis.
Method: A narrative review methodology was used in this study using comprehensive search of articles from PubMed and ScienceDirect databases, from 2020–2025. Research papers with in-vitro studies assessing the antibacterial activity of plant extracts against S. pyogenes, reporting Minimum Inhibitory Concentration (MIC) values, and involving plants that grow in Indonesia were included in this study. Articles not focused on microbiological activity were excluded.
Discussion: Eight selected articles reviewed various plant species with antimicrobial potential. Extracts from Spondias pinnata seeds and Sapindus rarak fruits showed the highest potency with MIC values of 0.000039 mg/mL. Active compounds such as flavonoids and saponins are known to act through quorum sensing inhibition and disruption of bacterial membranes. The efficacy of the extracts was influenced by the type of solvent and extraction method used.
Conclusion: Medicinal plants growing in Indonesia have promising potential as alternative therapies for pharyngitis caused by S. pyogenes. The bioactive compounds in these plants may offer effective, safe solutions to reduce antibiotic use and combat antimicrobial resistance.
References
1. Flores AR, Caserta MT. Pharyngitis. In: Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases [Internet]. Elsevier; 2015 [cited 2025 Apr 10]. p. 753-759.e2. Available from: https://linkinghub.elsevier.com/retrieve/pii/B978145574801300059X
2. Kartika Untari M, Fatimah S, Duanda Putri H, Riska Rahmawati A, Azzahra Puteri D, Syahla. Kajian Penggunaan Obat Yang Rasional Pada Faringitis Akut di Puskesmas X Karanganyar. IJPE [Internet]. 2024 Apr 30 [cited 2025 Apr 10];4(1). Available from: https://ejurnal.ung.ac.id/index.php/ijpe/article/view/25016
3. Brennan-Krohn T, Ozonoff A, Sandora TJ. Adherence to guidelines for testing and treatment of children with pharyngitis: a retrospective study. BMC Pediatr. 2018 Feb 9;18(1):43.
4. Gottlieb M, Long B, Koyfman A. Clinical Mimics: An Emergency Medicine-Focused Review of Streptococcal Pharyngitis Mimics. J Emerg Med. 2018 May;54(5):619–29.
5. Wolford RW, Goyal A, Belgam Syed SY, Schaefer TJ. Pharyngitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Apr 10]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK519550/
6. Kemenkes RI. PEDOMAN NASIONAL PELAYANAN KEDOKTERAN TATA LAKSANA TONSILITIS. 2018;
7. Muliawan H. A, Yuliyani EA. KAJIAN PUSTAKA: DIAGNOSIS DAN TATALAKSANA FARINGITIS. JMedHealth. 2023 Nov 12;10(10):2924–32.
8. Juergens S, Aman AT, Wibawa T. Bacterial Pharyngitis Pattern And Antibiotic Susceptibility Pattern Of Indonesians And Non-Indonesians Living In Jakarta. [Yogyakarta]: Universitas Gadjah Mada; 2020.
9. Kim S. Clinical manifestations, diagnosis, and antimicrobial resistance of group A streptococci infections. Ann Clin Microbiol. 2023 Dec 20;26(4):89–97.
10. Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022 Feb 12;399(10325):629–55.
11. Salam MdA, Al-Amin MdY, Salam MT, Pawar JS, Akhter N, Rabaan AA, et al. Antimicrobial Resistance: A Growing Serious Threat for Global Public Health. Healthcare. 2023 July 5;11(13):1946.
12. Kanwal S, Vaitla P. Streptococcus Pyogenes. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Apr 10]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK554528/
13. Harberger S, Goldin J, Graber M. Bacterial Pharyngitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Apr 21]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK559007/
14. Golińska E, Van Der Linden M, Więcek G, Mikołajczyk D, Machul A, Samet A, et al. Virulence factors of Streptococcus pyogenes strains from women in peri-labor with invasive infections. Eur J Clin Microbiol Infect Dis. 2016 May;35(5):747–54.
15. Stevens DL, Bryant AE. Necrotizing Soft-Tissue Infections. N Engl J Med. 2017 Dec 7;377(23):2253–65.
16. Leung AKC, Lam JM, Barankin B, Leong KF, Hon KL. Group A β-hemolytic Streptococcal Pharyngitis: An Updated Review. CPR. 2025 Jan;21(1):2–17.
17. Li LYJ, Wang SY, Tsai CY, Wu CJ. Group A streptococcal pharyngitis. BMJ Case Rep. 2021 Sept 30;14(9):e244871.
18. Sahu M, Sahoo PR. Strawberry Tongue in Streptococcal Pharyngitis. N Engl J Med. 2021 Mar 25;384(12):1144.
19. Sykes EA, Wu V, Beyea MM, Simpson MTW, Beyea JA. Pharyngitis: Approach to diagnosis and treatment. Can Fam Physician. 2020 Apr;66(4):251–7.
20. Pratama AMP, Mahmudah N. Perbandingan Hasil Uji Aktivitas Antibakteri Ekstrak Etanol Fraksi N-Heksana dan Fraksi Etil Asetat Daun Rambusa (Passiflora Foetida L.) terhadap Bakteri Streptococcus Pyogenes. jkk. 2024 Oct 14;378–89.
21. Barba-Ostria C, Carrera-Pacheco SE, Gonzalez-Pastor R, Heredia-Moya J, Mayorga-Ramos A, Rodríguez-Pólit C, et al. Evaluation of Biological Activity of Natural Compounds: Current Trends and Methods. Molecules. 2022 July 13;27(14):4490.
22. Brigitta P, Fatmawati NND, Budayanti NNS. UJI AKTIVITAS EKSTRAK ETANOL DAUN SAMBILOTO (Andrographis paniculata Nees) SEBAGAI ANTI BAKTERI Streptococcus pyogenes ATCC 19615. eum. 2021 Mar 30;10(3):94.
23. Javed B, Farooq F, Ibrahim M, Abbas HAB, Jawwad H, Zehra SS, et al. Antibacterial and antifungal activity of methanolic extracts of Salix alba L. against various disease causing pathogens. Braz J Biol. 2023;83:e243332.
24. Jayaraj P, Ramakrishnan H, Paulraj S, Govindarajan P, Muralidharan H, Prabakar M. Assessment of the Antimicrobial Effect of Momordica charantia (Bitter Gourd Oil) on Periodontal Pathogens: An In Vitro Study. Cureus [Internet]. 2024 Dec 6 [cited 2025 Apr 10]; Available from: https://www.cureus.com/articles/323626-assessment-of-the-antimicrobial-effect-of-momordica-charantia-bitter-gourd-oil-on-periodontal-pathogens-an-in-vitro-study
25. Lone AS, Ravindran KC, Jeandet P. Evaluation of antimicrobial activity and bioactive compound analysis of Verbascum thapsus L. A folklore medicinal plant. Phytomedicine Plus. 2024 Aug;4(3):100560.
26. Quenon C, Hennebelle T, Butaud JF, Ho R, Samaillie J, Neut C, et al. Antimicrobial Properties of Compounds Isolated from Syzygium malaccense (L.) Merr. and L.M. Perry and Medicinal Plants Used in French Polynesia. Life. 2022 May 14;12(5):733.
27. Dechayont B, Phuaklee P, Chunthorng-Orn J, Juckmeta T, Prajuabjinda O, Jiraratsatit K. Antibacterial, anti-inflammatory and antioxidant activities of Mahanintangtong and its constituent herbs, a formula used in Thai traditional medicine for treating pharyngitis. BMC Complement Med Ther. 2021 Dec;21(1):105.
28. Obistioiu D, Cocan I, Tîrziu E, Herman V, Negrea M, Cucerzan A, et al. Phytochemical Profile and Microbiological Activity of Some Plants Belonging to the Fabaceae Family. Antibiotics. 2021 June 1;10(6):662.
29. Edo GI, Onoharigho FO, Jikah AN, Ezekiel GO, Essaghah AEA, Ekokotu HA, et al. Evaluation of the physicochemical, phytochemical and anti-bacterial potential of Zingiber officinale (ginger). Food Chemistry Advances. 2024 June;4:100625.
30. Stevanato N, Hoscheid J, Peron AP, Coelho ÉMP, Da Silva C, Da Silva EA. Green extraction of valuable compounds from the byproduct of oil extraction from forage radish seed. Industrial Crops and Products. 2025 Feb;224:120257.
31. Henry Wright M, Jean Arnold MS, Jay Lee C, Courtney R, Carlson Greene A, Edwin Cock I. Qualitative Phytochemical Analysis and Antibacterial Activity Evaluation of Indian Terminalia spp. Against the Pharyngitis Causing Pathogen Streptococcus pyogenes. PC. 2016 Apr 1;6(2):85–92.
32. Wijesundara NM, Rupasinghe HPV. Bactericidal and Anti-Biofilm Activity of Ethanol Extracts Derived from Selected Medicinal Plants against Streptococcus pyogenes. Molecules. 2019 Mar 24;24(6):1165.
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