Antimicrobial Performance and Hemolytic Compatibility of Medicinal Plant Extracts: A Systematic Review
Main Article Content
Suci Putri Ramadani
Alvira Noer Effendi
Medicinal plant preparations have been extensively explored as sources of antimicrobial compounds. Nevertheless, antimicrobial activity should not be interpreted as direct evidence of biomedical applicability, because some bioactive extracts can disrupt erythrocyte membranes or produce blood-cell toxicity. Purpose: This systematic review integrates published evidence on medicinal plant extracts that were assessed for antimicrobial effects together with hemolytic or hemocompatibility-related safety. Methods: Literature searches were carried out in PubMed, Scopus, SpringerLink, Wiley Online Library, and MDPI using keyword combinations related to medicinal plants, antimicrobial activity, hemolysis, erythrocytes, and hemocompatibility. Articles published during 2014-2026 were selected using predetermined eligibility criteria. Results: The search retrieved 1,525 records. Following removal of 572 duplicates, 953 records were screened; 653 were excluded during title and abstract assessment, and 300 full-text reports were reviewed. Thirty studies fulfilled the inclusion criteria. The included articles mainly used in vitro antimicrobial approaches, such as inhibition-zone testing, MIC, MBC, antibiofilm, or antifungal assays, and paired them with hemolysis, erythrocyte membrane-stability, PBMC cytotoxicity, or related blood-cell safety assays. Conclusion: Medicinal plant extracts are best evaluated using an efficacy-safety perspective. Preparations that inhibit microbes at concentrations below hemolytic or cytotoxic thresholds represent stronger candidates for subsequent biomedical development.
World Health Organization. Global antibiotic resistance surveillance report 2025: summary. Geneva: World Health Organization; 2025.
World Health Organization. WHO bacterial priority pathogens list, 2024: bacterial pathogens of public health importance to guide research, development and strategies to prevent and control antimicrobial resistance. Geneva: World Health Organization; 2024.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi:10.1136/bmj.n71
Tran L, Tam DNH, Elshafay A, Dang T, Hirayama K, Huy NT. Quality assessment tools used in systematic reviews of in vitro studies: a systematic review. BMC Med Res Methodol. 2021;21:101. doi:10.1186/s12874-021-01295-w
Vaou N, Stavropoulou E, Voidarou C, Tsigalou C, Bezirtzoglou E. Towards advances in medicinal plant antimicrobial activity: a review study on challenges and future perspectives. Microorganisms. 2021;9(10):2041. doi:10.3390/microorganisms9102041
Angelini P. Plant-derived antimicrobials and their crucial role in combating antimicrobial resistance. Antibiotics. 2024;13(8):746. doi:10.3390/antibiotics13080746
Chassagne F, Samarakoon T, Porras G, Lyles JT, Dettweiler M, Marquez L, et al. A systematic review of plants with antibacterial activities: a taxonomic and phylogenetic perspective. Front Pharmacol. 2021;11:586548. doi:10.3389/fphar.2020.586548
Ramadani SP, Kusumaningrum HD, Hasanah U. Meta-analysis of the effect of garlic on microbial count in meat products. Jurnal Mutu Pangan: Indonesian Journal of Food Quality. 2025;12(1):14-25. doi:10.29244/jmpi.2025.12.1.14
Mehreen A, Waheed M, Liaqat I, Arshad N. Phytochemical, Antimicrobial, and Toxicological Evaluation of Traditional Herbs Used to Treat Sore Throat. BioMed research international. 2016. doi:10.1155/2016/8503426
Nunes TRDS, Cordeiro MF, Beserra FG, de Souza ML, da Silva WAV, Ferreira MRA, et al. Organic Extract of Justicia pectoralis Jacq. Leaf Inhibits Interferon-γ Secretion and Has Bacteriostatic Activity against Acinetobacter baumannii and Klebsiella pneumoniae. Evidence-based complementary and alternative medicine : eCAM. 2018. doi:10.1155/2018/5762368
Kibiti CM, Afolayan AJ. Preliminary Phytochemical Screening and Biological Activities of Bulbine abyssinica Used in the Folk Medicine in the Eastern Cape Province, South Africa. Evidence-based complementary and alternative medicine : eCAM. 2015. doi:10.1155/2015/617607
Saleem K, Hayat Z, Tariq Z, Riaz T, Azam M. Profiling of phenolic compounds, antimicrobial, antioxidant, and hemolytic activity of mango seed kernel using different optimized extraction systems. Journal of Food Science. 2023. doi:10.1111/1750-3841.16799
El Kamari F, Zouirech O, Metouekel A, Bouslamti M, Maliki I, El Moussaoui A, et al. Chemical Profiling and Antioxidant, Antimicrobial, and Hemolytic Properties of Euphorbia calyptrata (l.) Essential oils: in Vitro and in Silico Analysis. ChemistryOpen. 2024. doi:10.1002/open.202300243
Naicker D, Govender R, Abbai NS. Busting the Resistance: Antimicrobial Activity of Plant-Infused Nanoemulsions against Neisseria gonorrhoeae. International Journal of Microbiology. 2024. doi:10.1155/2024/7084347
Jamal A, Arif A, Kiran S, Shahid MN, Hossain MB. Inquisition of the Phytochemistry, Antioxidants, and Hemolytic and Antimicrobial Potential of Polar Extracts of Moringa oleifera Leaves Indigenously Grown in Pakistan. Journal of Chemistry. 2024. doi:10.1155/joch/9500215
Riaz M, Qadir R, Tahir Akhtar M, Misbah ur Rehman M, Anwar F, Eman R, et al. Chemical Characterization, Antioxidant, Antimicrobial, Cytotoxicity and in Silico Studies of Hexane Extract and Essential Oils from Citrus limon Leaves. Chemistry & Biodiversity. 2023. doi:10.1002/cbdv.202200537
Jamal A, Arif A, Kiran S, Shahid MN, Hossain MB. Phytochemical Investigations and Pharmacological Potential of Organic Extracts of Calotropis gigantea L. Leaves. Scientifica. 2025. doi:10.1155/sci5/1669969
Rafique S, Murtaza MA, Hafiz I, Ameer K, Qayyum MMN, Yaqub S, et al. Investigation of the antimicrobial, antioxidant, hemolytic, and thrombolytic activities of Camellia sinensis, Thymus vulgaris, and Zanthoxylum armatum ethanolic and methanolic extracts. Food Science & Nutrition. 2023. doi:10.1002/fsn3.3569
Sima Obiang C, Ndong Mba T, Ondo JP, Ngoua Meye Misso RL, Orango Bourdette JO, Otogo N’Nang E, et al. Toxicity, Antibacterial, and Phytochemical Analyses of Antrocaryon klaineanum Pierre Extracts. Advances in Pharmacological and Pharmaceutical Sciences. 2023. doi:10.1155/2023/9304681
Jamal A, Arif A, Zubair A, Kiran S, Shahid MN, Hossain MB. Exploring the Phytochemistry and Therapeutic Potential of Indigenously Grown Taraxacum officinale Leaves. Journal of Chemistry. 2025. doi:10.1155/joch/4385247
Assaf I, Jabbour Z, Abou Fayyad A, Borjac J. Exploring the Antibacterial and Antioxidant Effects of Rhus coriaria L. Aqueous Extract Against Carbapenem-Resistant Acinetobacter baumannii. International Journal of Microbiology. 2026. doi:10.1155/ijm/5238068
Aati HY, Al-Arifi R, Ovatlarnporn C, AlYami K, Rauf A, Basit A, et al. GC–MS Profiling and In Vitro and Silico Evaluation of Biological Propensities of Saudi Cultivar of Sugar Apple (Annona squamosa L.): A Preliminary Multidimensional Approach for the Development of Nutraceuticals. Food Science & Nutrition. 2025. doi:10.1002/fsn3.70723
Masuku M, Mozirandi W, Mukanganyama S. Evaluation of the Antibacterial and Antibiofilm Effects of Ethyl Acetate Root Extracts from Vernonia adoensis (Asteraceae) against Pseudomonas aeruginosa. The Scientific World Journal. 2023. doi:10.1155/2023/5782656
Machingauta A, Mukanganyama S. Antibacterial Activity and Proposed Mode of Action of Extracts from Selected Zimbabwean Medicinal Plants against Acinetobacter baumannii. Advances in Pharmacological and Pharmaceutical Sciences. 2024. doi:10.1155/2024/8858665
Andrade J, de Almeida-Apolonio AA, Dantas FGDS, Santos JIDS, Sangalli A, Negri M, et al. Phytochemical and Biological Evaluation of Leaves, Stems, and Roots of Schinus weinmanniifolia Mart. Ex Engl. Chemistry & Biodiversity. 2026. doi:10.1002/cbdv.202502974
Tsamo DLF, Tamokou JDD, Kengne IC, Ngnokam CDJ, Djamalladine MD, Voutquenne-Nazabadioko L, et al. Antimicrobial and Antioxidant Secondary Metabolites from Trifolium baccarinii Chiov. (Fabaceae) and Their Mechanisms of Antibacterial Action. BioMed Research International. 2021. doi:10.1155/2021/3099428
Alsharif KF, Rahman H. Antihemolytic and Thrombolytic Potential of Ocimum basilicum Seed Extract, Bioactive Compounds, and Docking With VanA Ligase in Vancomycin-Resistant Staphylococci. Journal of Tropical Medicine. 2026. doi:10.1155/jotm/6640607
Rangel MDL, Aquino SGD, Lima JMD, Castellano LR, Castro RDD. In Vitro Effect of Cinnamomum zeylanicum Blume Essential Oil on Candida spp. Involved in Oral Infections. Evidence-Based Complementary and Alternative Medicine. 2018. doi:10.1155/2018/4045013
Khanal A, Raut B, Khanal DP, Koirala N. Bioactivity evaluations from stem bark extract fractions of Myrica esculenta Buch. -Ham.ex D. Don. Food Safety and Health. 2024. doi:10.1002/fsh3.12063
Rahman MM, Soma MA, Sultana N, Hossain MJ, Sufian MA, Rahman MO, et al. Exploring therapeutic potential of Woodfordia fruticosa (L.) Kurz leaf and bark focusing on antioxidant, antithrombotic, antimicrobial, anti-inflammatory, analgesic, and antidiarrheal properties. Health Science Reports. 2023. doi:10.1002/hsr2.1654
Moyo B, Mukanganyama S. The Anticandidal and Toxicity Properties of Lampranthus francisci. Journal of Mycology. 2015. doi:10.1155/2015/898202
Alves DR, Maia de Morais S, Tomiotto-Pellissier F, Miranda-Sapla MM, Vasconcelos FR, Silva INGD, et al. Flavonoid Composition and Biological Activities of Ethanol Extracts of Caryocar coriaceum Wittm., a Native Plant from Caatinga Biome. Evidence-Based Complementary and Alternative Medicine. 2017. doi:10.1155/2017/6834218
Deng J, He B, He D, Chen Z. A potential biopreservative: Chemical composition, antibacterial and hemolytic activities of leaves essential oil from Alpinia guinanensis. Industrial Crops and Products. 2016. doi:10.1016/j.indcrop.2016.09.004
Al-Mazaideh GM, Al-Mustafa AH, Alnasser SMA, Nassir-Allah I, Tarawneh KA, Al-Rimawi F, et al. Phytochemical composition and bioactivities of Crataegus aronia as antioxidant, antibacterial and antioxidative stress in red blood cells – Is it a window of hope for children with glucose-6-phosphate dehydrogenase deficiency. Heliyon. 2022. doi:10.1016/j.heliyon.2022.e11516
Chansiw N, Paradee N, Chotinantakul K, Srichairattanakool S. Anti-hemolytic, antibacterial and anti-cancer activities of methanolic extracts from leaves and stems of Polygonum odoratum. Asian Pacific Journal of Tropical Biomedicine. 2018. doi:10.4103/2221-1691.248094
Sepahi S, Ghorani-Azam A, Soodeh AA, Rostami S. In vitro study to evaluate antibacterial and non-haemolytic activities of four Iranian medicinal plants. West Indian Medical Journal. 2014. doi:10.7727/wimj.2013.095
Mrani SA, Zejli H, Azzouni D, Fadili D, Alanazi MM, Hassane SOS, et al. Chemical Composition, Antioxidant, Antibacterial, and Hemolytic Properties of Ylang-Ylang (Cananga odorata) Essential Oil: Potential Therapeutic Applications in Dermatology. Pharmaceuticals. 2024. doi:10.3390/ph17101376
Dantas-Medeiros R, Zanatta AC, de Souza LBFC, Fernandes JM, Amorim-Carmo B, Torres-Rêgo M, et al. Antifungal and Antibiofilm Activities of B-Type Oligomeric Procyanidins From Commiphora leptophloeos Used Alone or in Combination With Fluconazole Against Candida spp. Frontiers in microbiology. 2021. doi:10.3389/fmicb.2021.613155
Bataineh SMB, Tarazi YH, Ahmad WA. Antibacterial efficacy of some medicinal plants on multidrug resistance bacteria and their toxicity on eukaryotic cells. Appl Sci. 2021;11(18):8479. doi:10.3390/app11188479
Hemthanon T, Ungcharoenwiwat P. Antibacterial activity, stability, and hemolytic activity of heartwood extract from Caesalpinia sappan for application on nonwoven fabric. Electron J Biotechnol. 2022;55:9-17. doi:10.1016/j.ejbt.2021.10.002
Rocha WRV, Nunes LE, Fernandes AFC, Catao RMR, Alves HS. Antimicrobial screening and hemolytic activity of products obtained from Piper montealegreanum Yuncker and effect in vitro on growth of Staphylococcus aureus. Res Soc Dev. 2020;9(9):e7410. doi:10.33448/rsd-v9i9.7410
Msengwa Z, Credo D, Mafuru M, Mwesongo J, Mabiki FPM, Mwangonde BJ, et al. Bacteriostatic and haemolytic activities of extracts and compounds of Commiphora swynnertonii. Res J Pharmacogn. 2023;10(2):47-56. doi:10.22127/rjp.2023.370231.2009













