Revitalizing Siddha Antimicrobial Knowledge for Modern Medical Applications
Keywords:
Siddha medicine, antimicrobial resistance, Linga Chendooram, Vishnu Chakara Mathirai, Adathodai Manapagu, multidrug-resistant bacteria, biofilm inhibition, integrative medicine.Abstract
Background:
Antimicrobial resistance (AMR) has emerged as a major global health threat, leading to reduced effectiveness of existing antibiotics and increased burden of infectious diseases worldwide. The rapid rise of multidrug-resistant (MDR) pathogens and the lack of new antimicrobial agents have intensified the need for alternative therapeutic strategies. Traditional Siddha medicine, one of the oldest indigenous systems of medicine from South India, contains a rich repository of herbal, mineral, and herbo-mineral formulations with historical use in infectious diseases. Classical preparations such as Linga Chendooram, Vishnu Chakara Mathirai, and Adathodai Manapagu are increasingly being explored for their antimicrobial potential.
Objective:
To systematically review the antimicrobial potential of selected Siddha formulations and evaluate available scientific evidence supporting their activity against pathogenic and multidrug-resistant microorganisms, with emphasis on their relevance to modern antimicrobial drug discovery and integrative medicine.
Methods:
A comprehensive literature review was conducted using databases including PubMed, Scopus, Web of Science, ScienceDirect, Google Scholar, SpringerLink, and AYUSH Research Portal covering studies published from 2000 to 2025. Classical Siddha texts, in vitro and in vivo studies, phytochemical analyses, molecular docking studies, and relevant review articles were included. Data related to antimicrobial activity, phytoconstituents, mechanisms of action, and clinical relevance were extracted and analyzed.
Results:
Available evidence indicates that Linga Chendooram, Vishnu Chakara Mathirai, and Adathodai Manapagu exhibit broad-spectrum antimicrobial activity against Gram-positive and Gram-negative bacteria, including multidrug-resistant strains such as MRSA and ESBL-producing organisms. Reported mechanisms include disruption of microbial cell membranes, inhibition of biofilm formation, suppression of quorum sensing, antioxidant effects, and immunomodulatory actions. The presence of bioactive compounds such as alkaloids, phenolics, and mineral-based constituents contributes to their therapeutic potential in infectious diseases.
Conclusion:
Siddha formulations demonstrate promising antimicrobial potential, particularly against MDR pathogens, and may serve as valuable candidates for future drug discovery and adjunct therapy. However, limited clinical evidence necessitates further pharmacological validation, toxicity assessment, and well-designed clinical trials to establish safety and efficacy for modern medical applications.
References
1. World Health Organization. (2014). Antimicrobial resistance: Global report on surveillance. World Health Organization.
2. Ventola, C. L. (2015). The antibiotic resistance crisis: Causes and threats. P&T, 40(4), 277–283.
3. Murray, C. J. L., Ikuta, K. S., Sharara, F., Swetschinski, L., Aguilar, G. R., Gray, A., et al. (2022). Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. The Lancet, 399(10325), 629–655.
4. O'Neill, J. (2016). Tackling drug-resistant infections globally: Final report and recommendations. Review on Antimicrobial Resistance.
5. Uthamarayan, K. S. (2005). Siddha Maruthuvanga Churukkam. Directorate of Indian Medicine and Homoeopathy.
6. Anonymous. (2012). Siddha system of medicine. Department of Indian Medicine and Homoeopathy.
7. Akbar, S. (2011). Andrographis paniculata: A review of pharmacological activities and clinical effects. Alternative Medicine Review, 16(1), 66–77.
8. Upadhyay, A. K., Kumar, K., Kumar, A., & Mishra, H. S. (2010). Tinospora cordifolia (Willd.) Hook. f. and Thomson: A review of its ethnobotany, phytochemistry and pharmacology. International Journal of Pharmaceutical Sciences and Research, 1(2), 18–34.
9. Prakash, P., & Gupta, N. (2005). Therapeutic uses of Ocimum sanctum Linn (Tulsi). Indian Journal of Physiology and Pharmacology, 49(2), 125–131.
10. Subapriya, R., & Nagini, S. (2005). Medicinal properties of neem leaves: A review. Current Medicinal Chemistry: Anti-Cancer Agents, 5(2), 149–156.
11. Cowan, M. M. (1999). Plant products as antimicrobial agents. Clinical Microbiology Reviews, 12(4), 564–582.
12. Silva, L. N., Zimmer, K. R., Macedo, A. J., & Trentin, D. S. (2016). Plant natural products targeting bacterial virulence factors. Chemical Reviews, 116(16), 9162–9236.
13. Gibbons, S. (2004). Anti-staphylococcal plant natural products. Natural Product Reports, 21(2), 263–277.
14. Hemaiswarya, S., Kruthiventi, A. K., & Doble, M. (2008). Synergism between natural products and antibiotics against infectious diseases. Phytomedicine, 15(8), 639–652.
15. Atanasov, A. G., Zotchev, S. B., Dirsch, V. M., & Supuran, C. T. (2021). Natural products in drug discovery: Advances and opportunities. Nature Reviews Drug Discovery, 20(3), 200–216.
16. Ministry of AYUSH. (2023). Siddha guidelines for prevention and management of infectious diseases. Government of India.
17. World Health Organization. (2020). WHO benchmarks for training in traditional and complementary medicine. World Health Organization.
18. World Health Organization. (2019). WHO global report on traditional and complementary medicine. World Health Organization.
19. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., et al. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71.
20. Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C. D., Gøtzsche, P. C., Ioannidis, J. P. A., et al. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses. BMJ, 339, b2700.
21. Higgins, J. P. T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., & Welch, V. A. (2019). Cochrane handbook for systematic reviews of interventions (2nd ed.). Wiley.
22. Ministry of AYUSH. (2024). AYUSH Research Portal. Government of India.
23. National Institute of Siddha. (2022). Siddha Formulary of India. Ministry of AYUSH.
24. Uthamarayan, K. S. (2008). Siddha Materia Medica (Medicinal Plants Division). Department of Indian Medicine and Homoeopathy.
25. World Health Organization. (2020). WHO benchmarks for training in traditional and complementary medicine. World Health Organization.
26. Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research, 104, 333–339.
27. Atanasov, A. G., Zotchev, S. B., Dirsch, V. M., & Supuran, C. T. (2021). Natural products in drug discovery: Advances and opportunities. Nature Reviews Drug Discovery, 20(3), 200–216.
28. Cowan, M. M. (1999). Plant products as antimicrobial agents. Clinical Microbiology Reviews, 12(4), 564–582.
29. Akbar, S. (2011). Andrographis paniculata: A review of pharmacological activities and clinical effects. Alternative Medicine Review, 16(1), 66–77.
30. Upadhyay, A. K., Kumar, K., Kumar, A., & Mishra, H. S. (2010). Tinospora cordifolia (Willd.) Hook. f. and Thomson: A review of its ethnobotany, phytochemistry and pharmacology. International Journal of Pharmaceutical Sciences and Research, 1(2), 18–34.
31. Subapriya, R., & Nagini, S. (2005). Medicinal properties of neem leaves: A review. Current Medicinal Chemistry: Anti-Cancer Agents, 5(2), 149–156.
32. Prakash, P., & Gupta, N. (2005). Therapeutic uses of Ocimum sanctum Linn (Tulsi). Indian Journal of Physiology and Pharmacology, 49(2), 125–131.
33. Krishnaveni, M., & Mirunalini, S. (2010). Therapeutic potential of Phyllanthus emblica (Amla): The Ayurvedic wonder. Journal of Basic and Clinical Physiology and Pharmacology, 21(1), 93–105.
34. Singh, N., Bhalla, M., de Jager, P., & Gilca, M. (2011). An overview on Ashwagandha: A Rasayana rejuvenator of Ayurveda. African Journal of Traditional, Complementary and Alternative Medicines, 8(5 Suppl.), 208–213.
35. Srinivasan, K. (2007). Black pepper and its pungent principle piperine: A review of diverse physiological effects. Critical Reviews in Food Science and Nutrition, 47(8), 735–748.
36. Gibbons, S. (2004). Anti-staphylococcal plant natural products. Natural Product Reports, 21(2), 263–277.
37. Hemaiswarya, S., Kruthiventi, A. K., & Doble, M. (2008). Synergism between natural products and antibiotics against infectious diseases. Phytomedicine, 15(8), 639–652.
38. Ministry of AYUSH. (2023). Siddha guidelines for prevention and management of infectious diseases. Government of India.
39. Murray, C. J. L., Ikuta, K. S., Sharara, F., Swetschinski, L., Robles Aguilar, G., Gray, A., et al. (2022). Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. The Lancet, 399(10325), 629–655.
40. World Health Organization. (2023). Antimicrobial resistance. World Health Organization.
41. Ventola, C. L. (2015). The antibiotic resistance crisis: Causes and threats. P&T, 40(4), 277–283.
42. Anonymous. (1972). Siddha Formulary of India (Part I). Ministry of AYUSH, Government of India.
43. Anonymous. (2008). The Siddha Pharmacopoeia of India (Part I, Vol. I). Ministry of AYUSH.
44. Thiyagarajan, R. (2004). Gunapadam Thathu Jeeva Vaguppu. Directorate of Indian Medicine and Homoeopathy.
45. Rajalakshmi, R., & Geetha, R. V. (2020). Evaluation of antimicrobial activity of Linga Chendooram against selected bacterial pathogens. International Journal of Research in Pharmaceutical Sciences, 11(SPL4), 1120–1124.
46. Kannan, M., & Devi, R. (2019). Pharmacological evaluation of Siddha herbo-mineral preparations: A review. Journal of Complementary and Integrative Medicine, 16(4), 1–10.
47. Rajeshkumar, S., & Menon, S. (2018). Antimicrobial efficacy of traditional Siddha formulations against common bacterial pathogens. Asian Journal of Pharmaceutical and Clinical Research, 11(6), 214–218.
48. Meenakshi, S., & Balamurugan, K. (2021). Immunomodulatory potential of Siddha formulations in infectious diseases. International Journal of Pharmaceutical Sciences Review and Research, 67(2), 45–51.
49. Dhivya, S., & Karthikeyan, M. (2015). Pharmacological activities of Justicia adhatoda: A review. International Journal of Pharmaceutical Sciences Review and Research, 35(1), 185–191.
50. Claeson, U. P., Malmfors, T., Wikman, G., & Bruhn, J. G. (2000). Adhatoda vasica: A critical review of ethnopharmacological and toxicological data. Journal of Ethnopharmacology, 72(1–2), 1–20.
51. Cowan, M. M. (1999). Plant products as antimicrobial agents. Clinical Microbiology Reviews, 12(4), 564–582.
52. Newman, D. J., & Cragg, G. M. (2020). Natural products as sources of new drugs over nearly four decades. Journal of Natural Products, 83(3), 770–803.
53. Atanasov, A. G., Zotchev, S. B., Dirsch, V. M., & Supuran, C. T. (2021). Natural products in drug discovery: Advances and opportunities. Nature Reviews Drug Discovery, 20(3), 200–216.
54. Patwardhan, B., Vaidya, A. D. B., & Chorghade, M. (2004). Ayurveda and natural products drug discovery. Current Science, 86(6), 789–799.
55. Efferth, T., & Koch, E. (2011). Complex interactions between phytochemicals and antimicrobial drugs. Planta Medica, 77(11), 1163–1174.
56. Ministry of AYUSH. (2023). Research and development in Siddha medicine. Government of India.
57. National Institute of Siddha. (2022). Siddha treatment guidelines. National Institute of Siddha.
58. Central Council for Research in Siddha. (2023). Research highlights. Central Council for Research in Siddha.
59. Anonymous. (n.d.). Agasthiyar Vaidhya Kaaviyam (Reprint ed.). Department of Indian Medicine.
60. Anonymous. (n.d.). Yugi Vaidhya Chinthamani (Reprint ed.). Department of Indian Medicine.
61. Balachandran, P., & Govindarajan, R. (2005). Cancer—An Ayurvedic perspective. Pharmacological Research, 51(1), 19–30.
62. Fabricant, D. S., & Farnsworth, N. R. (2001). The value of plants used in traditional medicine for drug discovery. Environmental Health Perspectives, 109(Suppl. 1), 69–75.
63. Hemaiswarya, S., Kruthiventi, A. K., & Doble, M. (2008). Synergism between natural products and antibiotics. Phytomedicine, 15(8), 639–652.
64. Lewis, K., & Ausubel, F. M. (2006). Prospects for plant-derived antibacterials. Nature Biotechnology, 24(12), 1504–1507.
