Send Orders for Reprints to reprints@benthamscience.ae Pharmaceutical Crops, 2016, 6, 1-12 1 2210-2906/16 2016 Bentham Open Pharmaceutical Crops Content list available at: www.benthamopen.com/TOPHARMCJ/ DOI: 10.2174/2210290601606010001 Inhibition of Enterobacter cloacae and Klebsiella oxytoca by Garlic (Allium sativum L.) and Garlic Pills Lucinda Choules 1,* , Dennis A. Gravatt 2,* , Stephen M. Kosovich 3 , Wei Yuan 4 , Wang Ping 4 and Ron Havner 2 1 Division of Multidisciplinary Programs, Arthur Temple College of Forestry and Agriculture, Stephen F. Austin State University, Nacogdoches, TX 75962, USA 2 Department of Biology, Arthur Temple College of Forestry and Agriculture, Stephen F. Austin State University, Nacogdoches, TX 75962, USA 3 Department of Economics, Arthur Temple College of Forestry and Agriculture, Stephen F. Austin State University, Nacogdoches, TX 75962, USA 4 National Center for Pharmaceutical crops, Arthur Temple College of Forestry and Agriculture, Stephen F. Austin State University, Nacogdoches, TX 75962, USA Received: October 22, 2015 Revised: February 1, 2016 Accepted: February 3, 2016 Abstract: Multidrug resistant infections and superinfections are increasing globally. Intrinsic and acquired resistance to multiple antibiotics by bacteria from the Enterobacteriaceae family exasperate treatment efforts by clinicians. Carbapenem antibiotics were once relied upon to treat multidrug resistant infections. However, Carbapenem Resistant Enterobacteriaceae (CRE) infections are becoming more common, requiring that an alternative treatment be found. This study trialed an ancient cure, Fresh Garlic Extract (FGE) created from garlic (Allium sativum L.) and commercially prepared garlic pills against two opportunistic Enterobacteriaceae in vitro utilizing: disc diffusion, well diffusion (introducing DIFF-bolts), and HPLC. FGE and four brands of garlic pills inhibited the growth of Enterobacter cloacae and Klebsiella oxytoca in vitro . General Nutrition Center (GNC) brand were found to be the most effective garlic pills producing comparable clear zones to meropenem (carbapenem antibiotic) for both bacteria. Garlicin produced the next largest clear zones followed by Garlique and Nature made. Five out of nine garlic pill brands tested were not found to contain viable allicin failing to produce clear zones in all microbial tests. Keywords: Allicin, disc diffusion, DIFF-bolts, Enterobacter cloacae, garlic, garlic pills, Klebsiella oxytoca, well diffusion. INTRODUCTION Multidrug resistant infections and super infections affected over two million Americans last year [1]. Carbapenem Resistant Enterobacteriaceae (CRE) is of particular concern as few other treatments are available to patients [ 2]. Recently in the news, multiple cases of CRE have been reported in hospitals across the country resulting in several deaths [3]. The CDC has classified CRE at a threat level of “urgent” as a high fatality rate (about half of all infected patients) is associated with these infections [4]. Enterobacter cloacae and Klebsiella oxytoca are opportunistic members of the Enterobacteriaceae family [5]. Both are facultatively anaerobic, gram-negative rods which are normal intestinal flora of humans and generally non- pathogenic to their host [ 6]. However, once released from their host in a nosocomial setting they may become pathogenic infecting immunocompromised individuals via biofilms on medical equipment or other fomites [6, 7]. Enterobacteriaceae bacteria possess intrinsic (innate) resistance to beta lactam antibiotics and can acquire resistance * Address correspondence to these authors at Department of Biology, Stephen F. Austin State University, Nacogdoches, TX 75962, USA; E-mails: Cindysbirdsandbooks@yahoo.com, dgravatt@sfasu.edu