Antimicrobial activity of natural products against Clostridium difficile in vitro

Document Type



Blackwell Publishing Ltd


School of Medical & Health Sciences


Originally published as : Roshan, N., Riley, T.V. and Hammer, K.A. (2017), Antimicrobial activity of natural products against Clostridium difficile in vitro. J Appl Microbiol, 123: 92–103. doi:10.1111/jam.13486. Article can be found here



To investigate the antimicrobial activity of various natural products against Clostridium difficile in vitro.

Methods and Results

The antibacterial activity of 20 natural products was determined by the agar well diffusion and broth microdilution assays against four C. difficile strains, three comparator organisms and four gastrointestinal commensal organisms. Of the raw natural products, garlic juice had the highest activity. The most active processed products were peppermint oil and the four pure compounds trans-cinnamaldehyde, allicin, menthol and zingerone. Furthermore, Bacteroides species had similar susceptibility to C. difficile to most natural products; however, Lactobacillus casei was less susceptible. The combined effect of natural products with vancomycin or metronidazole was determined using the conventional checkerboard titration method and the fractional inhibitory concentration index was calculated. The results showed a possible synergism between trans-cinnamaldehyde and vancomycin and partial synergy between trans-cinnamaldehyde and metronidazole.


The study indicates a range of antimicrobial activity of natural products against C. difficile and suggests that they may be useful as alternative or complementary treatments for C. difficile infection (CDI), particularly as most are able to be given orally.

Significance and Impact of the Study

This study encourages further investigation of natural products for treatment of CDI.