Thymoquinone from Nigella sativa (Habbatussauda) as an Anti-biofilm in Pseudomonas aeruginosa Infection: a Systematic Review
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Abstract
Background: Pseudomonas aeruginosa is responsible for 15% of hospital infections globally, with 50% of clinical isolates being MDR. Biofilms increase their resistance to antibiotics up to 1,000-fold. Therefore, alternative antimicrobials are important. In prophetic medicine, Nigella sativa is believed to be a medicinal plant with Thymoquinone as the main active component. This offers potential as an anti-biofilm agent that can be developed as an adjuvant therapy. This article aims to review this issue based on current scientific evidence. Methods: An electronic search of four databases published between 2015 and 2025. The study selection followed the PRISMA 2020 guideline. The data included were P. aeruginosa strain, Thymoquinone extract, and outcome (Zone of Inhibition (ZOI); Minimum Inhibitory Concentration (MIC); Biofilm activity reduction). The risk of bias was assessed using the Newcastle-Ottawa Scale. This Systematic Review has been submitted to PROSPERO, ID: 1056187. Results: Out of 330 articles, 12 were included in the systematic review. Organisms were P. aeruginosa from several strains (PAO1, ATCC, MTCC). The intervention used were various extract preparations of Thymoquinone from N. sativa (5 – 1600 µg/ml). The longest ZOI is 30 mm. The lowest MIC and MBC: 1,56 µg/ml. The largest portion of biofilm inhibition is up to 90%. The result of the vote counting direction of effect was that there were 10 of 12 studies favoring the intervention (83,3% probability of success (95% CI 51% to 97%), p-value = 0,038). Conclusion: Thymoquinone from N. sativa is an effective anti-biofilm of P. aeruginosa. In prophetic medicine, TQ could be a promising option as an adjuvant therapy.
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