Table 3.

Effects of propolis in combination with various drugs on different bacterial species.

Propolis Origin	Antibiotics	Bacterial Species	Activity	Ref.
Ireland	Two-drug combinations: vancomycin, oxacillin, and levofloxacin	MRSA	Propolis (MIC: 0.4–5 mg/mL) synergistically enhanced the efficacy of antibiotics, especially those acting on cell wall synthesis (vancomycin (0.2 mg/mL) and oxacillin (12.5 mg/mL)) on drug-resistant bacteria	[28]
Poland	Amikacin, kanamycin, gentamycin, tetracycline, and fusidic acid	S. aureus	Propolis (16–32 µg/mL) showed a synergistic effect in combination with various antibiotics (1–0.0312 µg/mL) that inhibit protein synthesis	[27]
	Cefoxitin, clindamycin, tetracycline, tobramycin, linezolid, trimethoprim + sulfamethoxazole, penicillin, and erythromycin	S. aureus clinical isolates	The combination of propolis (MIC: 0.39–0.78 mg/mL) with different drugs potentiated the antibacterial effect of eight antistaphylococcals (1–30 µg/mL) against all strains	[32]
Italy	Ampicillin, gentamycin, streptomycin, chloramphenicol, ceftriaxone, and vancomycin	S. aureus and S. epidermidis.	Propolis increased the antibacterial effect of ampicillin (0.05–3.12 µg/mL), gentamycin (0.05–1.56 µg/mL), and streptomycin (0.05–50 µg/mL); moderately for chloramphenicol (0.05–25 µg/mL), ceftriaxone, and vancomycin (0.39–3.15 µg/mL)	[33]
Nanoparticles prepared with Malaysian propolis	Rifampicin, ciprofloxacin, vancomycin, and doxycycline	S. epidermidis	Propolis nanoparticles (15.63–125 µg/mL disrupted bacterial biofilms by causing membrane damage and significantly reducing biofilm formation, and showed synergism with antibiotics (0.2–25 µg/mL)	[46]

MIC: minimum inhibitory concentration.