US20210106640A1

US20210106640A1 - Method of chinese herbal medicine extract used for treating multiple diseases caused by drug resistant bacteria infection

Info

Publication number: US20210106640A1
Application number: US17/129,885
Authority: US
Inventors: Weiwei Su; Chong Liu; Qian Zhou; Peibo LI; Wei Peng; Yonggang Wang
Original assignee: Sun Yat Sen University
Current assignee: Sun Yat Sen University
Priority date: 2016-05-10
Filing date: 2020-12-21
Publication date: 2021-04-15
Also published as: US11154582B2; US11654174B2; US20220023369A1; EP3456335B1; US20210106641A1; US20210106639A1; US20180200319A1; US11793849B2; EP3456335A4; US20220031789A1; WO2017193635A1; US11491198B2; WO2017193635A9; EP3456335A1

Abstract

Disclosed is a new drug application of a Pithecellobium clypearia Benth Extract (EA), and particularly is a method of the EA used for treating multiple diseases caused by drug resistant bacteria infection. Related drug resistant bacteria include a Multi-Drug Resistant (MDR) Acinetobacter baumannii (MDRAB), an MDR Pseudomonas aeruginosa (MDRPA), an Extended-Spectrum Beta-Lactamase (ESBL) producing Escherichia coli (ECO) and an ESBL-producing Klebsiella pneumonia (KPN).

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is divisional application of U.S. patent application Ser. No. 15/920,480 filed on Mar. 14, 2018, which is a continuation application of PCT application No. PCT/CN2017/071671 filed on Jan. 19, 2017, which claims the benefit of Chinese patent application Nos. 201610308716.7, 201610308717.1, 201610308207.4 and 201610308718.6, each filed on May 10, 2016. The contents of all of the above are hereby incorporated by reference.

TECHNICAL FIELD

The present disclosure relates to a new drug application of a Pithecellobium clypearia Benth Extract (EA), and particularly, to a method of the EA used for treating multiple diseases caused by drug resistant bacteria infection.

BACKGROUND

The twenty-first century is an age of Multi-Drug Resistant (MDR) bacteria. After 60 years of clinical use of an antibiotic, more and more hospital infections and infections with the MDR bacteria have become a major challenge to clinical antibacterial treatment at present. Since a first case of clinical Methicillin-Resistant Staphylococcus aureus (MRSA) infected patient was reported by Jerons in 1961, the MRSA infections have gradually spread all over the world till now. In 2011, China Bacterial Resistance Surveillance in clinic showed that, in distribution of main drug resistant bacteria, Escherichia coli and Klebsiella pneumonia produced Extended-Spectrum Beta-Lactamase (ESBL) strains respectively were 50.7% and 38.5%, and the transition and current status of the drug resistance thereof are highly concerned. In addition, according to an annual report 2010 from a Drug Resistance Surveillance Cooperating Group of Ministry of Health, pathogenic bacteria separated by Acinetobacter baumannii and Pseudomonas aeruginosa in a hospital ICU ranked the top, and the drug resistance rates of the Acinetobacter baumannii to imipenem (IMP) and meropenem respectively were up to 60.4% and 61.4%. To sum up, in various MRSA and ESBL produced bacteria, the clinical occupied rates of the MDR Acinetobacter baumannii (MDRAB) and Pseudomonas aeruginosa (MDRPA) have been growing every year. Under the pressure that the drug resistance rates are rising continuously, the antibiotic treatment is facing an enormous challenge. In order to prevent further deterioration of a bacterial drug resistant phenomenon, experts and scholars are sparing no effort to discover a new method for inhibiting bacterial growth and treating a bacteria-induced disease. A research has been reported and proved that traditional Chinese herbal medicines such as Coptis chinensis, Scutellaria baicalensis and Forsythia suspensa have a certain inhibition effect to different drug resistant bacteria. The key to further research the Chinese herbal medicine to inhibit the growth of the drug resistant bacteria is to discover a new Chinese herbal medicine with a stronger bactericidal capacity and a wider drug resistant inhibitory spectrum.
With Pithecellobium bigemimum (L.) Benth as a scientific name, the Pithecellobium clypearia Benth is dry young branches and leaves of mimosa pithecellobium plant that is the Pithecellobium clypearia Benth. It is cold, tastes bitter and has the effects of clearing away heat and toxic materials, astringing dampness and healing sore. It is a unique southern medicinal material for treating multiple heat toxin symptoms.
Currently, there has disclosed in a literature that the Pithecellobium clypearia Benth and an extract thereof have an antiviral effect, but lacks a research in an effect of the Pithecellobium clypearia Benth and the extract thereof in aspect of anti-drug resistant bacteria.

SUMMARY

In order to overcome the above defects, the present disclosure discloses an application of an EA in preparing a drug resistant bacteria resistant drug and in an aspect of a sensibilization effect by using with a similar antibiotic thereof, specifically:
1. a method of the EA used for treating disease caused by an MDRAB resistant infection, in which the EA is used with an antibiotic IMP or Tetracycline (TE) or Polymycin B (POLB) or Ceftazidime (CAZ) or Levofloxacin (LVX) and all show an obvious sensibilization effect;
2. a method of the EA used for treating disease caused by an MDRPA resistant infection, in which the EA is used with an antibiotic LVX or IMP or Amikacin (AMK) or CAZ or Cefoperazone (CFP) and all show an obvious sensibilization effect;
3. a method of the EA used for treating disease caused by an ESBL-producing Escherichia coli (ECO) resistant infection, in which the EA is used with an antibiotic AMK or Compound Sulfamethoxazole (SXT) and all show an obvious sensibilization effect;
4. a method of the EA used for treating disease caused by an ESBL-producing Klebsiella pneumonia (KPN) resistant infection, in which the EA shows an obvious inhibitory effect to the ESBL-producing KPN.
The EA preferably is a Pithecellobium clypearia Benth water extract or a Pithecellobium clypearia Benth ethanol extract.
A method for preparing the EA is as follows: extracting Pithecellobium clypearia Benth coarse powder with water or an ethanol aqueous solution having a concentration of 10%-95% by a volume ratio, and then extracting an obtained extracting solution with ethyl acetate, in which the obtained extract is a final product. The ethanol aqueous solution preferably is an ethanol aqueous solution having the concentration of 60% by the volume ratio.
In the present disclosure, the drug includes a human drug or an animal drug, or a soil treatment drug or preparation.
The present disclosure achieves the following beneficial effects.
The present disclosure first discloses the antibacterial effect of the EA to the MDRAB, the MDRPA, the ESBL-producing ECO and the ESBL-producing KPN and the sensibilization effect by using with the antibiotics thereof.
A test proves that the EA by using with the IMP or the TE or the POLB or the CAZ or the LVX has a synergistic effect to the MDRA resistance, and compared with the single use, the usage of the antibiotic is reduced by 50%-87%.
The EA by using with the LVX or the IMP or the AMK or the CAZ or the CFP has a synergistic effect to the MDRPA resistance, and compared with the single use, the usage of the antibiotic is reduced by 50%-99.2%.
The EA by using with the AMK or the SXT has a synergistic effect to the ESBL-producing ECO, and compared with the single use, the usage of the antibiotic is reduced by 75%-99.3%.
The EA in the present disclosure can be taken as a natural antibacterial drug for the above drug resistant bacteria or a sensitizer similar to the antibiotic, and is applied to treatment of a disease caused by the above bacteria. The present disclosure provides a new way and a replacement drug to solve the drug resistant problem of the antibiotics, and is applied to the human drug, other animal drugs and soil remediation of corresponding infectious bacteria. It is a natural plant extract and has no side effect, and the extracting method is simple and environment-friendly.

DETAILED DESCRIPTION OF THE EMBODIMENTS

The EA to resist the drug resistant bacteria and the pharmacological actions of the sensibilization effect to similar antibiotics will be further described with the reference to the following implementation solutions.
Preparation of the EA: the Pithecellobium clypearia Benth is provided by Guangzhou Huacheng Pharmaceutical Factory. An appropriate amount of Pithecellobium clypearia Benth medicinal materials are taken and are crushed into coarse powder; the coarse powder is reflowed for two times with water or with a 10%-95% ethanol aqueous solution, each time for 2 h, and is filtered; filtrates are merged and are condensed to obtain an extractum (namely, the Pithecellobium clypearia Benth water or ethanol extract); after being taken and suspended in the water, the extractum is extracted with ethyl acetate for three times, and ethyl acetate extracting solutions are merged and are condensed to obtain an ethyl acetate extract. The extract obtained by reflowing with a 10% ethanol aqueous solution is referred to as a Pithecellobium clypearia Benth 10% ethanol extract, and the extract obtained by reflowing with other concentrations of ethanol aqueous solutions are by that analogy.
Strains: test strains in the present disclosure all are provided by the Clinical Microbiology Lab of Department of Lab Medicine at First Affiliated Hospital of Sun Yat-Sen University and the drug resistance is tested and confirmed by the same.
Mycoplasma Hominis (MH) broth culture medium: 2.1 g of MH broth dry powder (British OXOID LTD.) is taken and a volume is fixed to 100 ml; the pH is adjusted to 7.0 with NAOH; and the culture medium is sterilized at a high pressure and is placed into a refrigerator at 4° C. for later use.
Determination methods of a Minimal Inhibitory Concentration (MIC) and a Minimum Bactericidal Concentration (MBC) of a test product: the MIC and the MBC of the Pithecellobium clypearia Benth water or ethanol extract to the MDRAB are determined by a microdilution broth method. And it is operated by referring to the microdilution broth method recommended by National Committee for Clinical Laboratory Standards (NCCLS).
Test methods of the sensibilization effects of the test product to similar antibiotics: it is operated by referring to a checkerboard assay recommended by NCCLS.
I. Inhibitory and Bactericidal Tests of MDRA Resistance of the EA and Test of the Sensibilization Effect by Respectively Using with the IMP or the TE or the POLB or the CAZ or the LVX

Embodiment 1

1. Test Method
1) MIC Determination
The EA, the IMP, the TE, the POLB, the CAZ and the LVX are respectively diluted in the MH broth culture medium by a series of ratios, with each pore for 50 μl; the inoculant bacteria are adjusted to 1.0*10⁶CFU/ml and 50 μl of a bacteria solution is added to each pore; the culture is at 35° C. and for 24 h; and the concentration, at which no precipitate occurs, of a minimum antibacterial drug is the MIC.
2) MBC Determination
A spread plate count method is adopted. 50 μl of bacterial suspension is absorbed from a pore for sterile growth in item 1) to a blood plate, is uniformly coated and is cultured for 24 h at 35° C. Bacterial colonies are counted, and the concentration, at which the initial number of experimental viable bacteria is reduced by 99.9% or more, of the minimum antibacterial drug is the MBC.
By determining the MIC and the MBC of the drug and making statistics of the data to obtain MIC₅₀, MIC₉₀, MBC₅₀and MBC₉₀, the effect of the MDRA resistance of the drug is evaluated.
3) Checkerboard Assay
The checkerboard assay is performed in a 96-pore sterile culture plate. The EA, the IMP, the TE, the POLB and the CAZ are respectively diluted into a series of concentrations in a doubling manner in the MH broth culture medium, and two drugs are combined respectively at ¼MIC to 4MIC; 25 μl of A drug and 25 μl of B drug are respectively added to each pore, the concentration of the bacterial suspension is adjusted to 1.0*10⁶CFU/ml, 50 μl of the bacteria solution is inoculated to each pore and is cultured for 24 h at 35° C.; and then, the MIC to the MDRAB after the A drug is used with the B drug is observed.
Calculation of a Fractional Inhibitory Concentration (FIC): FIC=S20b combined-use MIC/S20b single-use MIC+antibiotic combined-use MIC/antibiotic single-use MIC. By calculating the FIC, the combined antibacterial interaction between the EA and the antibiotic is evaluated, with synergistic effect for FIC≤0.5, additive effect for 0.5<FIC≤1, indifferent effect for 1<FIC≤2 and antagonistic effect for FIC>2. According to a sterile growth pore, the optimum concentration ratio between the EA and the antibiotic is founded out. At last, the effect of the EA to strengthen the efficacy of the antibiotic is evaluated.
The test products in the embodiment include: the Pithecellobium clypearia Benth water extract, the Pithecellobium clypearia Benth 10% ethanol extract, the Pithecellobium clypearia Benth 60% ethanol extract and the Pithecellobium clypearia Benth 95% ethanol extract.
The MDRABs are numbered as A1-A20.
2. Test Results
2.1 In-vitro inhibitory test results of the Pithecellobium clypearia Benth water extract and the five antibiotics (the IMP, the TE, the POLB, the CAZ and LVX) to the MDRABs are shown in table A1.
In-vitro bactericidal test results of the Pithecellobium clypearia Benth water extract to the MDRABs are shown in table A2.
The statistic analysis on in-vitro inhibitory and bactericidal MIC₅₀and MIC₉₀of the Pithecellobium clypearia Benth water extract and the five antibiotics to the MDRABs is shown in table A3.
The statistic analysis on MBC₅₀and MBC₉₀of the Pithecellobium clypearia Benth water extract to the MDRABs is shown in table A4.
FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth water extract and the five antibiotics and distribution statistical results of the FIC values are shown in table A5 and table A6.
The sensibilization effects of the Pithecellobium clypearia Benth water extract to the five antibiotics and the MIC₅₀and MIC₉₀after combined use are shown in tables A7-A12.

TABLE A1

In-vitro inhibitory test results of the Pithecellobium clypearia
Benth water extract and the five antibiotics to the MDRABs

MIC (μg/ml)

Strain No.	EA	IMP	TE	LVX	CAZ	POLB

A1	600	1	2	0.5	128	8
A2	600	32	256	16	512	2
A3	600	32	256	4	512	2
A4	600	8	8	0.5	256	2
A5	600	32	32	4	64	4
A6	600	32	256	8	>512	8
A7	600	32	512	8	>512	4
A8	600	32	256	4	512	8
A9	600	32	256	4	512	1
A10	600	16	128	32	512	32
A11	600	32	256	4	512	16
A12	600	32	512	32	512	2
A13	600	32	512	32	256	2
A14	600	32	256	16	512	0.5
A15	1200	32	>512	32	256	2
A16	600	32	512	8	512	4
A17	600	16	512	16	256	64
A18	600	32	512	8	512	4
A19	600	32	512	16	256	4
A20	600	32	256	16	512	2
ATCC27853	300	1	8	1	4	1

TABLE A2

In-vitro bactericidal test results of the Pithecellobium clypearia
Benth water extract to the MDRABs

	Strain No.	MBC (μg/ml)

	A1	1200
	A2	1200
	A3	1200
	A4	1200
	A5	1200
	A6	1200
	A7	1200
	A8	1200
	A9	1200
	A10	1200
	A11	1200
	A12	1200
	A13	1200
	A14	1200
	A15	2400
	A16	1200
	A17	1200
	A18	1200
	A19	1200
	A20	1200

TABLE A3

Statistical results on in-vitro inhibitory MIC₅₀
and MIC₉₀of the Pithecellobium clypearia Benth
water extract and the antibiotics to the MDRABs

MIC (μg/ml)

	Drug	Range	MIC₅₀	MIC₉₀

EA	600-1200	600	600
IMP	1-32	32	32
TE	2-512	256	512
POLB	0.5-64	4	16
CAZ	64-512	512	512
LVX	0.5-32	8	32

TABLE A4

Bactericidal MIC₅₀and MIC₉₀of the Pithecellobium clypearia
Benth water extract to the MDRABs

MBC (μg/ml)

Drug	Range	MBC₅₀	MBC₉₀

EA	1200-2400	1200	1200

TABLE A5

FIC values of the combined drug sensitive test of the Pithecellobium
clypearia Benth water extract and the five antibiotics

Strain

FIC

No.	EA + IMP	EA + TE	EA + POLB	EA + CAZ	EA + LVX

A1	1	1	1.5	0.75	0.625
A2	1	1	1	1	1.5
A3	1	0.75	1.25	0.75	0.375
A4	0.625	0.75	0.5	0.625	0.375
A5	1.5	0.375	0.375	1	0.5
A6	1	0.5	0.5	1	1
A7	1	1	0.75	1	1
A8	1	1	1.007813	1	1.25
A9	1.5	0.75	1.0625	0.375	0.265625
A10	1	1.5	0.5	1	0.75
A11	1.25	0.75	0.5	1	1
A12	1	0.75	1.03125	0.5	0.5625
A13	1.5	0.5	1.5	1	0.75
A14	0.375	0.375	0.625	0.375	1
A15	0.375	0.3125	0.53125	1	0.501953
A16	0.5	0.625	0.515625	1.125	0.5
A17	0.375	1.25	1.03125	0.625	1
A18	0.375	0.75	1.5	1	0.375
A19	0.5	0.375	1	1	1
A20	0.5	0.5	1	0.375	0.5

TABLE A6

Distribution statistics of the FIC values of the combined
drug sensitive test of the Pithecellobium clypearia
Benth water extract and the five antibiotics

	EA +	EA +	EA +	EA +	EA +
FIC_Range	IMP	TE	POLB	CAZ	LVX

FIC ≤ 0.5	35%	35%	25%	20%	35%
0.5 < FIC ≤ 1	45%	55%	35%	75%	55%
1 < FIC ≤ 2	20%	10%	40%	5%	10%
FIC > 2	—	—	—	—	—

TABLE A7

Sensibilization effect of the Pithecellobium clypearia
Benth water extract to the IMP and MIC after combined use

	EA	EA	IMP	IMP
Strain	single-use	combined-use	single-use	combined-use
No.	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)

A1	600	300	1	0.5
A2	600	300	32	16
A3	600	300	32	16
A4	600	300	8	1
A5	600	600	32	16
A6	600	300	32	16
A7	600	300	32	16
A8	600	300	32	16
A9	600	600	32	16
A10	600	300	16	8
A11	600	600	32	8
A12	600	300	32	16
A13	600	600	32	16
A14	600	150	32	4
A15	1200	300	32	4
A16	600	150	32	8
A17	600	150	16	2
A18	600	75	32	8
A19	600	150	32	8
A20	600	150	32	8

TABLE A8

Sensibilization effect of the Pithecellobium clypearia
Benth water extract to the TE and MIC after combined use

	EA	EA	TE	TE
Strain	single-use	combined-use	single-use	combined-use
No.	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)

A1	600	300	2	1
A2	600	300	256	128
A3	600	300	256	64
A4	600	300	8	2
A5	600	150	32	4
A6	600	150	256	64
A7	600	300	512	256
A8	600	300	256	128
A9	600	300	256	64
A10	600	600	128	64
A11	600	300	256	64
A12	600	150	512	256
A13	600	150	512	128
A14	600	150	256	32
A15	1200	300	1024	64
A16	600	300	512	64
A17	600	600	512	128
A18	600	300	512	128
A19	600	150	512	64
A20	600	150	256	64

TABLE A9

Sensibilization effect of the Pithecellobium clypearia
Benth water extract to the POLB and MIC after combined use

	EA	EA	POLB	POLB
Strain	single-use	combined-use	single-use	combined-use
No.	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)

A1	600	600	8	4
A2	600	300	2	1
A3	600	600	2	0.5
A4	600	150	2	0.5
A5	600	150	4	0.5
A6	600	150	8	2
A7	600	300	4	1
A8	600	600	8	0.0625
A9	600	600	1	0.0625
A10	600	150	32	8
A11	600	150	16	4
A12	600	600	2	0.0625
A13	600	600	2	1
A14	600	300	0.5	0.0625
A15	1200	600	2	0.0625
A16	600	300	4	0.0625
A17	600	600	64	2
A18	600	600	4	2
A19	600	300	4	2
A20	600	300	2	1

TABLE A10

Sensibilization effect of the Pithecellobium clypearia
Benth water extract to the CAZ and MIC after combined use

	EA	EA	CAZ	CAZ
Strain	single-use	combined-use	single-use	combined-use
No.	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)

A1	600	150	128	64
A2	600	300	512	256
A3	600	150	512	256
A4	600	300	256	32
A5	600	300	64	32
A6	600	300	1024	512
A7	600	300	1024	512
A8	600	300	512	256
A9	600	150	512	64
A10	600	300	512	256
A11	600	300	512	256
A12	600	150	512	128
A13	600	300	256	128
A14	600	150	512	64
A15	1200	600	256	128
A16	600	600	512	64
A17	600	300	256	32
A18	600	300	512	256
A19	600	300	256	128
A20	600	150	512	64

TABLE A11

Sensibilization effect of the Pithecellobium clypearia
Benth water extract to the LVX and MIC after combined use

	EA	EA	LVX	LVX
Strain	single-use	combined-use	single-use	combined-use
No.	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)

A1	600	300	0.5	0.0625
A2	600	300	16	16
A3	600	150	16	2
A4	600	150	0.5	0.0625
A5	600	150	4	1
A6	600	300	8	4
A7	600	300	8	4
A8	600	150	4	4
A9	600	150	4	0.0625
A10	600	300	32	8
A11	600	300	4	2
A12	600	300	32	2
A13	600	300	32	8
A14	600	300	16	8
A15	1200	600	32	0.0625
A16	600	150	8	2
A17	600	300	16	8
A18	600	150	8	1
A19	600	300	16	8
A20	600	150	16	4

TABLE A12

MIC₅₀and MIC₉₀of the five antibiotics after combined use

Antibiotic (μg/ml)

Combined drug	MIC₅₀after combined use	MIC₉₀after combined use

EA + IMP	8	16
EA + TE	64	128
EA + POLB	1	4
EA + CAZ	128	256
EA + LVX	2	8

With the single use of the Pithecellobium clypearia Benth water extract to the MDRABs, the MIC₅₀is 600 μg/ml, the MIC₉₀is 600 μg/ml, the MBC₅₀is 1200 μg/ml, and the MBC₉₀is 1200 μg/ml.
It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth water extract and the IMP that the two drugs have the synergistic effect or partial synergistic effect, wherein 35% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the concentration of the Pithecellobium clypearia Benth water extract is smaller than or equal to the single-use MIC, the MIC₅₀of the IMP is reduced from single-use 32 μg/ml to 8 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 32 μg/ml to 16 μg/ml and is reduced by 50%.
It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth water extract and the TE to the 20 MDRABs that the two drugs have the synergistic effect or partial synergistic effect, wherein 35% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth water extract is smaller than or equal to the single-use MIC, the MIC₅₀of the TE is reduced from single-use 256 μg/ml to 64 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 512 μg/ml to 128 μg/ml and is reduced by 75%.
For the 20 MDRABs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth water extract and the POLB that the two drugs have no antagonistic effect, wherein 25% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth water extract is smaller than or equal to the single-use MIC, the MIC₅₀of the POLB is reduced from single-use 4 μg/ml to 1 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 16 μg/ml to 4 μg/ml and is reduced by 75%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth water extract and the CAZ to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 20% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth water extract is smaller than or equal to the single-use MIC, the MIC₅₀of the CAZ is reduced from single-use 512 μg/ml to 128 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth water extract and the LVX to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 35% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRAB, when the Pithecellobium clypearia Benth water extract is smaller than or equal to the single-use MIC, the MIC₅₀of the LVX is reduced from single-use 8 μg/ml to 2 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 32 μg/ml to 8 μg/ml and is reduced by 75%.
2.2. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 10% ethanol extract and the five antibiotics (the IMP, the TE, the POLB, the CAZ and the LVX) to the MDRABs are shown in table A13.
In-vitro bactericidal test results of the Pithecellobium clypearia Benth 10% ethanol extract to the MDRABs are shown in table A14.
The statistic analysis on in-vitro inhibitory and bactericidal MIC₅₀and MIC₉₀of the Pithecellobium clypearia Benth 10% ethanol extract and the five antibiotics to the MDRABs is shown in table A15.
The statistic analysis on MBC₅₀and MBC₉₀of the EA to the MDRABs is shown in table A16.
FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 10% ethanol extract and the five antibiotics and distribution statistical results of the FIC values are shown in table A17 and table A18.
The sensibilization effects of the Pithecellobium clypearia Benth 10% ethanol extract to the five antibiotics and the MIC₅₀and MIC₉₀after combined use are shown in tables A19-A24.

TABLE A13

In-vitro inhibitory test results of the Pithecellobium clypearia
Benth 10% ethanol extract and the five antibiotics to the MDRABs

MIC (μg/ml)

Strain No.	EA	IMP	TE	LVX	CAZ	POLB

A1	600	1	2	0.5	128	8
A2	600	32	256	16	512	2
A3	600	32	256	4	512	2
A4	600	8	8	0.5	256	2
A5	600	32	32	4	64	4
A6	600	32	256	8	>512	8
A7	600	32	512	8	>512	4
A8	600	32	256	4	512	8
A9	600	32	256	4	512	1
A10	600	16	128	32	512	32
A11	600	32	256	4	512	16
A12	600	32	512	32	512	2
A13	600	32	512	32	256	2
A14	600	32	256	16	512	0.5
A15	600	32	>512	32	256	2
A16	600	32	512	8	512	4
A17	600	16	512	16	256	64
A18	600	32	512	8	512	4
A19	600	32	512	16	256	4
A20	600	32	256	16	512	2
ATCC27853	300	1	8	1	4	1

TABLE A14

In-vitro bactericidal test results of the Pithecellobium clypearia
Benth 10% ethanol extract to the MDRABs

	Strain No.	MBC (μg/ml)

	A1	1200
	A2	1200
	A3	1200
	A4	1200
	A5	1200
	A6	1200
	A7	1200
	A8	1200
	A9	1200
	A10	1200
	A11	1200
	A12	1200
	A13	1200
	A14	1200
	A15	1200
	A16	1200
	A17	1200
	A18	1200
	A19	1200
	A20	1200

TABLE A15

Statistical results on in-vitro inhibitory MIC₅₀and
MIC₉₀of the Pithecellobium clypearia Benth 10%
ethanol extract and the antibiotics to the MDRABs

MIC (μg/ml)

	Drug	Range	MIC₅₀	MIC₉₀

EA	600	600	600
IMP	1-32	32	32
TE	2-512	256	512
POLB	0.5-64	4	16
CAZ	64-512	512	512
LVX	0.5-32	8	32

TABLE A16

bactericidal MBC₅₀and MBC₉₀of the Pithecellobium clypearia
Benth 10% ethanol extract to the MDRABs

MBC (μg /ml)

Drug	Range	MBC₅₀	MBC₉₀

EA	1200	1200	1200

TABLE A17

FIC values of the combined drug sensitive test of the Pithecellobium
clypearia Benth 10% ethanol extract and the five antibiotics

Strain

FIC

No.	EA + IMP	EA + TE	EA + POLB	EA + CAZ	EA + LVX

A1	1	1	1	1	0.625
A2	0.75	0.75	1	1	1
A3	0.75	0.75	1	1	0.625
A4	1.5	0.5	1	0.5	0.625
A5	0.5	0.375	0.75	1	1
A6	0.625	0.75	0.375	1	1
A7	0.5	0.5	0.375	1	1
A8	1	0.5	0.507813	0.75	1
A9	0.375	0.375	0.5625	0.75	0.265625
A10	0.75	0.75	0.375	1	0.75
A11	0.5	0.5	1	0.75	1
A12	0.5	0.5	1	0.75	0.75
A13	0.5	1	1	1	0.75
A14	1	1	0.625	0.375	1
A15	0.75	0.625	1	1	1
A16	0.5	1	0.75	0.5	0.75
A17	0.75	0.375	0.75	0.5	0.5
A18	1	0.5	0.75	1	1
A19	0.5	1	0.75	0.5	0.375
A20	0.5	1.5	1	0.5	0.5

TABLE A18

Distribution statistics of the FIC values of the combined
drug sensitive test of the Pithecellobium clypearia
Benth 10% ethanol extract and the five antibiotics

	EA +	EA +	EA +	EA +	EA +
FIC Range	IMP	TE	POLB	CAZ	LVX

FIC ≤ 0.5	45%	45%	15%	30%	20%
0.5 < FIC ≤ 1	50%	50%	85%	70%	80%
1 < FIC ≤ 2	5%	5%	—	—	—
FIC > 2	—	—	—	—	—

TABLE A19

Sensibilization effect of the Pithecellobium clypearia Benth
10% ethanol extract to the IMP and MIC after combined use

A1	600	300	1	0.5
A2	600	300	32	8
A3	600	300	32	8
A4	600	300	8	8
A5	600	150	32	8
A6	600	300	32	4
A7	600	150	32	8
A8	600	300	32	16
A9	600	75	32	8
A10	600	150	16	8
A11	600	150	32	8
A12	600	150	32	8
A13	600	150	32	8
A14	600	300	32	16
A15	600	300	32	8
A16	600	150	32	8
A17	600	300	16	4
A18	600	300	32	16
A19	600	150	32	8
A20	600	150	32	8

TABLE A20

Sensibilization effect of the Pithecellobium clypearia Benth
10% ethanol extract to the TE and MIC after combined use

A1	600	300	2	1
A2	600	300	256	64
A3	600	300	256	64
A4	600	150	8	2
A5	600	150	32	4
A6	600	300	256	64
A7	600	150	512	128
A8	600	150	256	64
A9	600	150	256	32
A10	600	300	128	32
A11	600	150	256	64
A12	600	150	512	128
A13	600	300	512	256
A14	600	300	256	128
A15	600	300	1024	128
A16	600	300	512	256
A17	600	150	512	64
A18	600	150	512	128
A19	600	300	512	256
A20	600	300	256	256

TABLE A21

Sensibilization effect of the Pithecellobium clypearia Benth
10% ethanol extract to the POLB and MIC after combined use

A1	600	300	8	4
A2	600	300	2	1
A3	600	300	2	1
A4	600	300	2	1
A5	600	300	4	1
A6	600	150	8	1
A7	600	75	4	1
A8	600	300	8	0.0625
A9	600	300	1	0.0625
A10	600	150	32	4
A11	600	300	16	8
A12	600	300	2	1
A13	600	300	2	1
A14	600	300	0.5	0.0625
A15	600	300	2	1
A16	600	300	4	1
A17	600	300	64	16
A18	600	300	4	1
A19	600	300	4	1
A20	600	300	2	1

TABLE A22

Sensibilization effect of the Pithecellobium clypearia Benth
10% ethanol extract to the CAZ and MIC after combined use

A1	600	300	128	64
A2	600	300	512	256
A3	600	300	512	256
A4	600	150	256	64
A5	600	300	64	32
A6	600	300	1024	512
A7	600	300	1024	512
A8	600	150	512	256
A9	600	300	512	128
A10	600	300	512	256
A11	600	300	512	128
A12	600	300	512	128
A13	600	300	256	128
A14	600	150	512	64
A15	600	300	256	128
A16	600	150	512	128
A17	600	150	256	64
A18	600	300	512	256
A19	600	150	256	64
A20	600	150	512	128

TABLE A23

Sensibilization effect of the Pithecellobium clypearia Benth
10% ethanol extract to the LVX and MIC after combined use

A1	600	300	0.5	0.0625
A2	600	300	16	8
A3	600	300	16	2
A4	600	300	0.5	0.0625
A5	600	300	4	2
A6	600	300	8	4
A7	600	300	8	4
A8	600	300	4	2
A9	600	150	4	0.0625
A10	600	300	32	8
A11	600	300	4	2
A12	600	300	32	8
A13	600	300	32	8
A14	600	300	16	8
A15	600	300	32	16
A16	600	150	8	4
A17	600	150	16	4
A18	600	300	8	4
A19	600	150	16	2
A20	600	150	16	4

TABLE A24

MIC₅₀and MIC₉₀of the five antibiotics after combined use

Antibiotic (μg/ml)

Combined drug	MIC₅₀after combined use	MIC₉₀after combined use

EA + IMP	8	16
EA + TE	64	256
EA + POLB	1	4
EA + CAZ	128	256
EA + LVX	4	8

With the single use of the Pithecellobium clypearia Benth 10% ethanol extract to the MDRABs, the MIC₅₀is 600 μg/ml, the MIC₉₀is 600 μg/ml, the MBC₅₀is 1200 μg/ml, and the MBC₉₀is 1200 μg/ml.
It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the IMP that the two drugs have the synergistic effect or partial synergistic effect, wherein 45% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the concentration of the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to ½ of the single-use MIC, the MIC₅₀of the IMP is reduced from single-use 32 μg/ml to 8 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 32 μg/ml to 16 μg/ml and is reduced by 50%.
It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the TE to the 20 MDRABs that the two drugs have the synergistic effect or partial synergistic effect, wherein 45% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to ½ of the single-use MIC, the MIC₅₀of the TE is reduced from single-use 256 μg/ml to 64 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.
For the 20 MDRABs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the POLB that the two drugs have no antagonistic effect, wherein 15% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the POLB is reduced from single-use 4 μg/ml to 1 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 16 μg/ml to 4 μg/ml and is reduced by 75%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the CAZ to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 30% with FIC≤0.5 have the synergistic effect. When an ethyl acetate extract of the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to ½ of the single-use MIC, the MIC₅₀of the CAZ is reduced from single-use 512 μg/ml to 128 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the LVX to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 25% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the LVX is reduced from single-use 8 μg/ml to 4 μg/ml and is reduced by 50%; and the MIC₉₀is reduced from 32 μg/ml to 8 μg/ml and is reduced by 75%.
2.3. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 60% ethanol extract and the five antibiotics (the IMP, the TE, the POLB, the CAZ and the LVX) to the MDRABs are shown in table A25.
In-vitro bactericidal test results of the Pithecellobium clypearia Benth 60% ethanol extract to the MDRABs are shown in table A26.
The statistic analysis on in-vitro inhibitory and bactericidal MIC₅₀and MIC₉₀of the Pithecellobium clypearia Benth 60% ethanol extract and the five antibiotics to the MDRABs is shown in table A27.
The statistic analysis on MBC₅₀and MBC₉₀of the EA to the MDRABs is shown in table A28.
FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 60% ethanol extract and the five antibiotics and distribution statistical results of the FIC values are shown in table A29 and table A30.
The sensibilization effects of the Pithecellobium clypearia Benth 60% ethanol extract to the five antibiotics and the MIC₅₀and MIC₉₀after combined use are shown in tables A31-A36.

TABLE A25

In-vitro inhibitory test results of the Pithecellobium clypearia
Benth 60% ethanol extract and the five antibiotics to the MDRABs

MIC (μg/ml)

Strain No.	EA	IMP	TE	LVX	CAZ	POLB

A1	300	1	2	0.5	128	8
A2	300	32	256	16	512	2
A3	600	32	256	4	512	2
A4	600	8	8	0.5	256	2
A5	300	32	32	4	64	4
A6	300	32	256	8	>512	8
A7	300	32	512	8	>512	4
A8	300	32	256	4	512	8
A9	600	32	256	4	512	1
A10	300	16	128	32	512	32
A11	600	32	256	4	512	16
A12	300	32	512	32	512	2
A13	300	32	512	32	256	2
A14	600	32	256	16	512	0.5
A15	600	32	>512	32	256	2
A16	300	32	512	8	512	4
A17	300	16	512	16	256	64
A18	300	32	512	8	512	4
A19	300	32	512	16	256	4
A20	300	32	256	16	512	2
ATCC27853	300	1	8	1	4	1

TABLE A26

In-vitro bactericidal test results of the Pithecellobium clypearia
Benth 60% ethanol extract to the MDRABs

	Strain No.	MBC (μg/ml)

	A1	600
	A2	600
	A3	1200
	A4	1200
	A5	600
	A6	600
	A7	600
	A8	1200
	A9	600
	A10	600
	A11	600
	A12	600
	A13	600
	A14	1200
	A15	1200
	A16	1200
	A17	600
	A18	600
	A19	600
	A20	600

TABLE A27

Statistics on in-vitro inhibitory MIC₅₀and
MIC₉₀of the Pithecellobium clypearia Benth 60%
ethanol extract and the antibiotics to the MDRABs

MIC (μg/ml)

	Drug	Range	MIC₅₀	MIC₉₀

EA	300-600	300	600
IMP	1-32	32	32
TE	2-512	256	512
POLB	0.5-64	4	16
CAZ	64-512	512	512
LVX	0.5-32	8	32

TABLE A28

Bactericidal MBC₅₀and MIC₉₀of the Pithecellobium clypearia
Benth 60% ethanol extract to the MDRABs

MBC (μg/ml)

Drug	Range	MBC₅₀	MBC₉₀

EA	600-1200	600	1200

TABLE A29

FIC values of the combined drug sensitive test of the Pithecellobium
clypearia Benth 60% ethanol extract and the five antibiotics

Strain

FIC

No.	EA + IMP	EA + TE	EA + POLB	EA + CAZ	EA + LVX

A1	0.75	0.75	1.5	0.75	0.375
A2	0.5	0.5	1.25	0.75	1.25
A3	0.375	0.375	1	0.5	1.0040
A4	0.1875	0.625	0.75	0.5	0.625
A5	0.5	0.75	1	0.75	1.25
A6	0.625	0.75	0.5	1	1
A7	0.625	0.75	0.75	0.75	1
A8	0.625	0.625	1.0080	0.75	1.25
A9	0.375	0.375	0.5625	0.625	0.5156
A10	0.75	0.75	0.5	0.75	1.0020
A11	0.375	0.375	0.5	0.625	1.125
A12	0.3125	0.5	1.25	0.75	1.03125
A13	0.5	0.5	1.5	1	1.0020
A14	0.25	0.375	0.625	0.625	0.625
A15	0.375	0.3125	0.53125	0.75	0.5020
A16	0.5	0.5	1.0156	0.75	0.75
A17	0.625	1	1.03125	0.75	0.75
A18	0.5	0.625	1.125	0.75	0.75
A19	0.375	0.5	1.125	1	1
A20	0.5	0.625	1.25	1	1

TABLE A30

Distribution statistics of the FIC values of the combined
drug sensitive test of the Pithecellobium clypearia
Benth 60% ethanol extract and the five antibiotics

	EA +	EA +	EA +	EA +	EA +
FIC Range	IMP	TE	POLB	CAZ	LVX

FIC ≤ 0.5	70%	50%	15%	10%	5%
0.5 < FIC ≤ 1	30%	50%	35%	85%	55%
1 < FIC ≤ 2	—	—	50%	5%	40%
FIC > 2	—	—	—	—	—

TABLE A31

Sensibilization effect of the Pithecellobium clypearia Benth
60% ethanol extract to the IMP and MIC after combined use

A1	300	75	1	0.5
A2	300	75	32	8
A3	600	75	32	8
A4	600	75	8	0.5
A5	300	75	32	8
A6	300	37.5	32	16
A7	300	37.5	32	16
A8	300	37.5	32	16
A9	600	150	32	4
A10	300	75	16	8
A11	600	150	32	4
A12	300	18.75	32	8
A13	300	75	32	8
A14	600	75	32	4
A15	600	150	32	4
A16	300	75	32	8
A17	300	150	16	2
A18	300	75	32	8
A19	300	37.5	32	8
A20	300	75	32	8

TABLE A32

Sensibilization effect of the Pithecellobium clypearia Benth
60% ethanol extract to the TE and MIC after combined use

A1	300	75	2	1
A2	300	75	256	64
A3	600	150	256	32
A4	600	300	8	1
A5	300	150	32	8
A6	300	75	256	128
A7	300	150	512	128
A8	300	150	256	32
A9	600	150	256	32
A10	300	150	128	32
A11	600	150	256	32
A12	300	75	512	128
A13	300	75	512	128
A14	600	150	256	32
A15	600	150	1024	64
A16	300	75	512	128
A17	300	150	512	256
A18	300	150	512	64
A19	300	75	512	128
A20	300	150	256	32

TABLE A33

Sensibilization effect of the Pithecellobium clypearia Benth
60% ethanol extract to the POLB and MIC after combined use

A1	300	300	8	4
A2	300	300	2	0.5
A3	600	300	2	1
A4	600	150	2	1
A5	300	150	4	2
A6	300	75	8	2
A7	300	75	4	2
A8	300	300	8	0.0625
A9	600	300	1	0.0625
A10	300	75	32	8
A11	600	150	16	4
A12	300	300	2	0.5
A13	300	300	2	1
A14	600	300	0.5	0.0625
A15	600	300	2	0.0625
A16	300	300	4	0.0625
A17	300	300	64	2
A18	300	300	4	0.5
A19	300	300	4	0.5
A20	300	300	2	0.5

TABLE A34

Sensibilization effect of the Pithecellobium clypearia Benth
60% ethanol extract to the CAZ and MIC after combined use

A1	300	75	128	64
A2	300	150	512	128
A3	600	150	512	128
A4	600	150	256	64
A5	300	75	64	32
A6	300	150	1024	512
A7	300	150	1024	256
A8	300	75	512	256
A9	600	300	512	64
A10	300	150	512	128
A11	600	300	512	64
A12	300	150	512	128
A13	300	150	256	128
A14	600	75	512	256
A15	600	150	256	128
A16	300	150	512	128
A17	300	75	256	128
A18	300	150	512	128
A19	300	150	256	128
A20	300	150	512	256

TABLE A35

Sensibilization effect of the Pithecellobium clypearia Benth
60% ethanol extract to the LVX and MIC after combined use

A1	300	75	0.5	0.0625
A2	300	75	16	16
A3	300	300	16	0.0625
A4	600	300	0.5	0.0625
A5	300	75	4	4
A6	300	150	8	4
A7	300	150	8	4
A8	300	75	4	4
A9	600	300	4	0.0625
A10	300	300	32	0.0625
A11	600	75	4	4
A12	300	300	32	1
A13	300	300	32	0.0625
A14	600	75	16	8
A15	600	300	32	0.0625
A16	300	75	8	4
A17	300	150	16	4
A18	300	75	8	4
A19	300	150	16	8
A20	300	150	16	8

TABLE A36

MIC₅₀and MIC₉₀of the five antibiotics after combined use

Antibiotic (μg/ml)

Combined drug	MIC₅₀after combined use	MIC₉₀after combined use

EA + IMP	8	16
EA + TE	32	128
EA + POLB	0.5	4
EA + CAZ	128	256
EA + LVX	4	8

With the single use of the Pithecellobium clypearia Benth 60% ethanol extract to the MDRABs, the MIC₅₀is 300 μg/ml, the MIC₉₀is 600 μg/ml, the MBC₅₀is 600 μg/ml, and the MBC₉₀is 1200 μg/ml.
It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the IMP that the two drugs have the synergistic effect or partial synergistic effect, wherein 70% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the concentration of the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to ½ of the single-use MIC, the MIC₅₀of the IMP is reduced from single-use 32 μg/ml to 8 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 32 μg/ml to 16 μg/ml and is reduced by 50%.
It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the TE to the 20 MDRABs that the two drugs have the synergistic effect or partial synergistic effect, wherein 50% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to ½ of the single-use MIC, the MIC₅₀of the TE is reduced from single-use 256 μg/ml to 32 μg/ml and is reduced by 87.5%; and the MIC₉₀is reduced from 512 μg/ml to 128 μg/ml and is reduced by 75%.
For the 20 MDRABs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the POLB that the two drugs have no antagonistic effect, wherein 15% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the POLB is reduced from single-use 4 μg/ml to 0.5 μg/ml and is reduced by 87.5%; and the MIC₉₀is reduced from 16 μg/ml to 4 μg/ml and is reduced by 75%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the CAZ to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 10% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to ½ of the single-use MIC, the MIC₅₀of the CAZ is reduced from single-use 512 μg/ml to 128 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the LVX to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 5% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the LVX is reduced from single-use 8 μg/ml to 4 μg/ml and is reduced by 50%; and the MIC₉₀is reduced from 32 μg/ml to 8 μg/ml and is reduced by 75%.
2.4. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 95% ethanol extract and the five antibiotics (the IMP, the TE, the POLB, the CAZ and the LVX) to the MDRABs are shown in table A37.
In-vitro bactericidal test results of the Pithecellobium clypearia Benth 95% ethanol extract to the MDRABs are shown in table A38.
The statistic analysis on in-vitro inhibitory and bactericidal MIC₅₀and MIC₉₀of the Pithecellobium clypearia Benth 95% ethanol extract and the five antibiotics to the MDRABs is shown in table A39.
The statistic analysis on MBC₅₀and MBC₉₀of the EA to the MDRABs is shown in table A40.
FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 95% ethanol extract and the five antibiotics and distribution statistical results of the FIC values are shown in table A41 and table A42.
The sensibilization effects of the Pithecellobium clypearia Benth 95% ethanol extract to the five antibiotics and the MIC₅₀and MIC₉₀after combined use are shown in tables A43-A48.

TABLE A37

In-vitro inhibitory test results of the Pithecellobium clypearia
Benth 95% ethanol extract and the five antibiotics to the MDRABs

MIC (μg/ml)

Strain No.	EA	IMP	TE	LVX	CAZ	POLB

TABLE A38

In-vitro bactericidal test results of the Pithecellobium clypearia
Benth 95% ethanol extract to the MDRABs

	Strain No.	MBC (μg/ml)

	A1	1200
	A2	1200
	A3	1200
	A4	1200
	A5	1200
	A6	1200
	A7	1200
	A8	1200
	A9	1200
	A10	1200
	A11	1200
	A12	1200
	A13	1200
	A14	1200
	A15	1200
	A16	1200
	A17	1200
	A18	1200
	A19	1200
	A20	1200

TABLE A39

Statistical results on in-vitro inhibitory MIC₅₀and
MIC₉₀of the Pithecellobium clypearia Benth 95%
ethanol extract and the antibiotics to the MDRABs

MIC (μg/ml)

	Drug	Range	MIC₅₀	MIC₉₀

TABLE A40

Bactericidal MBC₅₀and MBC₉₀of the Pithecellobium clypearia
Benth 95% ethanol extract to the MDRABs

MBC (μg/ml)

Drug	Range	MBC₅₀	MBC₉₀

EA	1200	1200	1200

TABLE A41

FIC values of the combined drug sensitive test of the Pithecellobium
clypearia Benth 95% ethanol extract and the five antibiotics

Strain

FIC

No.	EA + IMP	EA + TE	EA + POLB	EA + CAZ	EA + LVX

A1	0.75	0.75	1	1	1
A2	0.5	0.5	0.75	0.75	1
A3	0.5	0.375	1	0.75	0.625
A4	0.3125	0.625	1	0.75	0.375
A5	0.75	0.5	1	1	1
A6	0.75	1	0.5	1	1
A7	0.75	0.75	0.75	0.5	1
A8	0.75	0.625	0.625	1	1
A9	0.375	0.625	0.75	1	0.515625
A10	0.75	0.75	0.5	1	0.3125
A11	0.375	0.625	0.5	0.625	1.5
A12	0.5	0.75	1	0.75	0.53125
A13	0.75	0.5	1	0.75	0.5625
A14	0.75	0.375	1	1	1
A15	0.75	0.3125	0.28125	0.75	0.3125
A16	0.5	0.75	0.515625	1	0.75
A17	0.375	0.75	0.5625	1	0.5
A18	0.5	0.75	0.75	0.5	1
A19	0.5	0.75	0.75	0.75	1
A20	0.5	0.625	0.75	1	0.75

TABLE A42

Distribution statistics of the FIC values of the combined
drug sensitive test of the Pithecellobium clypearia
Benth 95% ethanol extract and the five antibiotics

	EA +	EA +	EA +	EA +	EA +
FIC Range	IMP	TE	POLB	CAZ	LVX

FIC ≤ 0.5	55%	30%	20%	10%	20%
0.5 < FIC ≤ 1	45%	70%	80%	90%	75%
1 < FIC ≤ 2	—	—	—	—	5%
FIC > 2	—	—	—	—	—

TABLE A43

Sensibilization effect of the Pithecellobium clypearia Benth
95% ethanol extract to the IMP and MIC after combined use

A1	600	150	1	0.5
A2	600	150	32	8
A3	600	150	32	8
A4	600	150	8	0.5
A5	600	300	32	8
A6	600	150	32	16
A7	600	150	32	16
A8	600	150	32	16
A9	600	150	32	4
A10	600	150	16	8
A11	600	150	32	4
A12	600	150	32	8
A13	600	300	32	8
A14	600	300	32	8
A15	1200	600	32	8
A16	600	150	32	8
A17	600	150	16	2
A18	600	150	32	8
A19	600	150	32	8
A20	600	150	32	8

TABLE A44

Sensibilization effect of the Pithecellobium clypearia Benth
95% ethanol extract to the TE and MIC after combined use

A1	600	150	2	1
A2	600	150	256	64
A3	600	150	256	32
A4	600	300	8	1
A5	600	150	32	8
A6	600	300	256	128
A7	600	300	512	128
A8	600	300	256	32
A9	600	300	256	32
A10	600	300	128	32
A11	600	300	256	32
A12	600	300	512	128
A13	600	150	512	128
A14	600	150	256	32
A15	1200	300	1024	64
A16	600	300	512	128
A17	600	300	512	128
A18	600	300	512	128
A19	600	300	512	128
A20	600	300	256	32

TABLE A45

Sensibilization effect of the Pithecellobium clypearia Benth
95% ethanol extract to the POLB and MIC after combined use

A1	600	300	8	4
A2	600	300	2	0.5
A3	600	300	2	1
A4	600	300	2	1
A5	600	300	4	2
A6	600	150	8	2
A7	600	150	4	2
A8	600	300	8	1
A9	600	300	1	0.25
A10	600	150	32	8
A11	600	150	16	4
A12	600	300	2	1
A13	600	300	2	1
A14	600	300	0.5	0.25
A15	1200	300	2	0.0625
A16	600	300	4	0.0625
A17	600	300	64	4
A18	600	300	4	1
A19	600	300	4	1
A20	600	300	2	0.5

TABLE A46

Sensibilization effect of the Pithecellobium clypearia Benth
95% ethanol extract to the CAZ and MIC after combined use

A1	600	300	128	64
A2	600	300	512	128
A3	600	300	512	128
A4	600	300	256	64
A5	600	300	64	32
A6	600	300	1024	512
A7	600	150	1024	256
A8	600	300	512	256
A9	600	300	512	256
A10	600	300	512	256
A11	600	300	512	64
A12	600	300	512	128
A13	600	150	256	128
A14	600	300	512	256
A15	1200	300	256	128
A16	600	300	512	256
A17	600	300	256	128
A18	600	150	512	128
A19	600	150	256	128
A20	600	300	512	256

TABLE A47

Sensibilization effect of the Pithecellobium clypearia Benth
95% ethanol extract to the LVX and MIC after combined use

A1	600	300	0.5	0.25
A2	600	300	16	8
A3	600	300	16	2
A4	600	150	0.5	0.0625
A5	600	300	4	2
A6	600	300	8	4
A7	600	300	8	4
A8	600	300	4	2
A9	600	300	4	0.0625
A10	600	150	32	2
A11	600	300	4	4
A12	600	300	32	1
A13	600	300	32	2
A14	600	300	16	8
A15	1200	300	32	2
A16	600	150	8	4
A17	600	150	16	4
A18	600	300	8	4
A19	600	300	16	8
A20	600	150	16	8

TABLE A48

MIC₅₀and MIC₉₀of the five antibiotics after combined use

Antibiotic (μg/ml)

Combined drug	MIC₅₀after combined use	MIC₉₀after combined use

EA + IMP	8	16
EA + TE	32	128
EA + POLB	1	4
EA + CAZ	128	256
EA + LVX	4	8

With the single use of the Pithecellobium clypearia Benth 95% ethanol extract to the MDRABs, the MIC₅₀is 600 μg/ml, the MIC₉₀is 600 μg/ml, the MBC₅₀is 1200 μg/ml, and the MBC₉₀is 1200 μg/ml.
It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the IMP that the two drugs have the synergistic effect or partial synergistic effect, wherein 55% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the concentration of the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the IMP is reduced from single-use 32 μg/ml to 8 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 32 μg/ml to 16 μg/ml and is reduced by 50%.
It is indicated by FIC≤1 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the TE to the 20 MDRABs that the two drugs have the synergistic effect or partial synergistic effect, wherein 35% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the TE is reduced from single-use 256 μg/ml to 32 μg/ml and is reduced by 87.5%; and the MIC₉₀is reduced from 512 μg/ml to 128 μg/ml and is reduced by 75%.
For the 20 MDRABs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the POLB that the two drugs have no antagonistic effect, wherein 20% with FIC≤0.5 have the synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the POLB is reduced from single-use 4 μg/ml to 1 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 16 μg/ml to 4 μg/ml and is reduced by 75%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the CAZ to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 10% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the CAZ is reduced from single-use 512 μg/ml to 128 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the LVX to the 20 MDRABs that the two drugs have no antagonistic effect, wherein 20% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRABs, when the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the LVX is reduced from single-use 8 μg/ml to 4 μg/ml and is reduced by 50%; and the MIC₉₀is reduced from 32 μg/ml to 8 μg/ml and is reduced by 75%.
II. Inhibitory and Bactericidal Tests of the MDRPA Resistance of the EA and Test of the Sensibilization Effect by Respectively Using with the LVX, the IMP, the AMK, the CAZ and the CFP

Embodiment 2

1. Test method: the MDRPA (serial No.: P1-P20) strains are tested and are evaluated with reference to the method in the first embodiment.
2. Test Results:
2.1. In-vitro inhibitory test results of the Pithecellobium clypearia Benth water extract and the five antibiotics (the LVX, the IMP, the AMK, the CAZ and the CFP) to the MDRPAs are shown in table P1.
In-vitro bactericidal test results of the Pithecellobium clypearia Benth water extract to the MDRPAs are shown in table P2.
The statistic analysis on in-vitro inhibitory and bactericidal MIC₅₀and MIC₉₀of the EA and the five antibiotics to the MDRPAs is shown in table P3.
The statistic analysis on MBC₅₀and MBC₉₀of the EA to the MDRPAs is shown in table P4.
FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth water extract and the five antibiotics and distribution statistical results of the FIC values are shown in table P5 and table P6.
The sensibilization effects of the Pithecellobium clypearia Benth water extract to the five antibiotics and the MIC₅₀and MIC₉₀after combined use are shown in tables P7-P12.

TABLE P1

In-vitro inhibitory test results of the Pithecellobium clypearia
Benth water extract and the five antibiotics to the MDRPAs

MIC(μg/ml)

Strain No.	EA	LVX	IMP	AMK	CAZ	CFP

P1	800	32	32	1	32	128
P2	800	4	64	1	64	256
P3	800	8	64	4	4	16
P4	800	8	32	1	256	8
P5	800	1	64	2	64	512
P6	1600	0.5	32	256	512	512
P7	800	32	32	1	64	512
P8	1600	1	64	1	256	16
P9	800	4	32	1	8	64
P10	800	128	64	4	4	8
P11	800	2	8	1	2	8
P12	800	1	32	32	64	512
P13	800	2	8	2	16	256
P14	800	32	32	2	16	8
P15	800	2	32	2	256	64
P16	1600	32	16	256	32	>512
P17	800	4	16	1	32	16
P18	800	4	32	16	64	256
P19	800	16	64	1	4	64
P20	800	4	4	2	256	>512
ATCC27853	400	1	4	2	4	8

TABLE P2

In-vitro bactericidal test results of the Pithecellobium clypearia
Benth water extract to the MDRPAs

	Strain No.	MBC (μg/ml)

	P1	1600
	P2	1600
	P3	1600
	P4	1600
	P5	1600
	P6	1600
	P7	1600
	P8	1600
	P9	1600
	P10	1600
	P11	1600
	P12	1600
	P13	1600
	P14	3200
	P15	1600
	P16	1600
	P17	1600
	P18	1600
	P19	3200
	P20	1600

TABLE P3

Statistical results on in-vitro inhibitory MIC₅₀and
MIC₉₀of the Pithecellobium clypearia Benth water
extract and the five antibiotics to the MDRPAs

MIC (μg/ml)

	Drug	Range	MIC₅₀	MIC₉₀

EA	800-1600	800	1600
CAZ	2-512	32	256
CFP	8-512	64	512
AMK	1-256	1	32
IMP	4-64	32	64
LVX	0.5-128	4	32

TABLE P4

Bactericidal MBC₅₀and MBC₉₀of the Pithecellobium clypearia
Benth water extract to the MDRPAs

MBC (μg/ml)

Drug	Range	MBC₅₀	MBC₉₀

EA	1600-3200	1600	1600

TABLE P5

FIC values of the combined drug sensitive test of the Pithecellobium
clypearia Benth water extract and the five antibiotics

FIC

Strain	EA +	EA +	EA +	EA +	EA +
No.	CAZ	CFP	AMK	IMP	LVX

P1	0.5	0.375	0.5625	1	0.625
P2	0.5	1	0.1875	0.28125	0.507813
P3	0.75	0.375	0.375	0.28125	0.503906
P4	0.5	1	1.5	1.0625	0.75
P5	1	0.75	1.03125	0.5	0.53125
P6	0.625	0.75	0.75	0.5625	0.3125
P7	0.75	0.53125	0.5625	1.0625	1.000977
P8	0.375	0.15625	0.75	0.28125	0.28125
P9	1	1	0.5625	1	1
P10	1	0.5625	0.375	0.5	0.375
P11	1	0.75	1	0.75	1
P12	0.53125	0.250977	0.3125	0.5625	1
P13	0.5	0.375	0.28125	0.5	1
P14	1	0.5625	0.53125	0.625	1.03125
P15	1	0.5	0.53125	0.5	1.5
P16	0.5	0.375	0.250244	0.375	0.5625
P17	0.5	0.53125	0.5625	0.75	2
P18	0.5	0.75	0.5	0.625	2.03125
P19	1	0.507813	0.5625	0.5625	0.75
P20	0.5	0.500488	0.625	1	0.75

TABLE P6

Distribution statistical results of the FIC values of the
combined drug sensitive test of the Pithecellobium clypearia
Benth water extract and the five antibiotics

	EA +	EA +	EA +	EA +	EA +
FIC Range	CAZ	CFP	AMK	IMP	LVX

FIC ≤ 0.5	45%	35%	35%	40%	15%
0.5 < FIC ≤ 1	55%	65%	55%	50%	60%
1 < FIC ≤ 2	—	—	10%	10%	25%
FIC > 2	—	—	—	—	—

TABLE P7

Sensibilization effect of the Pithecellobium clypearia
Benth water extract to the CAZ and MIC after combined use

P1	800	200	32	8
P2	800	200	64	16
P3	800	200	4	2
P4	800	200	256	64
P5	800	400	64	32
P6	1600	200	512	256
P7	800	200	64	32
P8	1600	200	256	64
P9	800	400	8	4
P10	800	400	4	2
P11	800	400	2	1
P12	800	400	64	2
P13	800	200	16	4
P14	800	400	16	8
P15	800	400	256	128
P16	1600	400	32	8
P17	800	200	32	8
P18	800	200	64	16
P19	800	400	4	2
P20	800	200	256	64

TABLE P8

Sensibilization effect of the Pithecellobium clypearia
Benth water extract to the CFP and MIC after combined use

	EA	EA	CFP	CFP
Strain	single-use	combined-use	single-use	combined-use
No.	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)

P1	800	100	128	32
P2	800	400	256	128
P3	800	200	16	2
P4	800	400	8	4
P5	800	200	512	256
P6	1600	400	512	256
P7	800	400	512	16
P8	1600	200	16	0.5
P9	800	400	64	32
P10	800	400	8	0.5
P11	800	200	8	4
P12	800	200	512	0.5
P13	800	200	256	32
P14	800	400	8	0.5
P15	800	200	64	16
P16	1600	200	1024	256
P17	800	400	16	0.5
P18	800	200	256	128
P19	800	400	64	0.5
P20	800	400	1024	0.5

TABLE P9

Sensibilization effect of the Pithecellobium clypearia
Benth water extract to the AMK and MIC after combined use

	EA	EA	AMK	AMK
Strain	single-use	combined-use	single-use	combined-use
No.	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)

P1	800	400	1	0.0625
P2	800	100	1	0.0625
P3	800	100	4	1
P4	800	800	1	0.5
P5	800	800	2	0.0625
P6	1600	800	256	64
P7	800	400	1	0.0625
P8	1600	400	1	0.5
P9	800	400	1	0.0625
P10	800	100	4	1
P11	800	400	1	0.5
P12	800	50	32	8
P13	800	200	2	0.0625
P14	800	400	2	0.0625
P15	800	400	2	0.0625
P16	1600	400	256	0.0625
P17	800	400	1	0.0625
P18	800	200	16	4
P19	800	400	1	0.0625
P20	800	100	2	1

TABLE P10

Sensibilization effect of the Pithecellobium clypearia
Benth water extract to the IMP and MIC after combined use

P1	800	400	32	16
P2	800	200	64	2
P3	800	200	64	2
P4	800	800	32	2
P5	800	200	64	16
P6	1600	800	32	2
P7	800	800	32	2
P8	1600	400	64	2
P9	800	400	32	16
P10	800	200	64	16
P11	800	200	8	4
P12	800	400	32	2
P13	800	200	8	2
P14	800	400	32	4
P15	800	200	32	8
P16	1600	400	16	2
P17	800	400	16	4
P18	800	400	32	4
P19	800	400	64	4
P20	800	400	4	2

TABLE P11

Sensibilization effect of the Pithecellobium clypearia
Benth water extract to the LVX and MIC after combined use

P1	800	400	32	4
P2	800	400	4	0.03125
P3	800	400	8	0.03125
P4	800	200	8	4
P5	800	400	1	0.03125
P6	1600	400	0.5	0.03125
P7	800	800	32	0.03125
P8	1600	400	1	0.03125
P9	800	400	4	2
P10	800	100	128	32
P11	800	400	2	1
P12	800	400	1	0.5
P13	800	400	2	1
P14	800	800	32	1
P15	800	800	2	1
P16	1600	800	32	2
P17	800	800	4	4
P18	800	25	4	8
P19	800	400	16	4
P20	800	400	4	1

TABLE P12

MIC₅₀and MIC₉₀of the five antibiotics after combined use

Antibiotic (μg/ml)

Combined drug	MIC₅₀after combined use	MIC₉₀after combined use

EA + CAZ	8	64
EA + CFP	0.5	256
EA + AMK	0.0625	2
EA + IMP	2	16
EA + LVX	1	8

With the single use of the EA to the MDRPA, the MIC₅₀is 800 μg/ml, the MIC₉₀is 1600 μg/ml, the MBC₅₀is 1600 μg/ml, and the MBC₉₀is 1600 μg/ml.
For the 20 MDRPAs, it is indicated by FIC≤2 with the combined use of the EA and the CAZ that the two drugs have no antagonistic effect, wherein 45% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the EA is smaller than or equal to the single-use MIC, the MIC₅₀of the CAZ is reduced from single-use 32 μg/ml to 8 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 256 μg/ml to 64 μg/ml and is reduced by 75%.
It is indicated by FIC≤2 with the combined use of the EA and the CFP to the 20 MDRPAs that the two drugs have no antagonistic effect, wherein 35% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the EA is smaller than or equal to the single-use MIC, the MIC₅₀of the CFP is reduced from single-use 64 μg/ml to 0.5 μg/ml and is reduced by 99.2%; and the MIC₉₀is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.
It is indicated by FIC≤2 with the combined use of the EA and the AMK that the two drugs have no antagonistic effect, wherein 35% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the EA is smaller than or equal to the single-use MIC, the MIC₅₀of the AMK is reduced from single-use 1 μg/ml to 0.0625 μg/ml and is reduced by 93.75%; and the MIC₉₀is reduced from 32 μg/ml to 2 μg/ml and is reduced by 93.75%.
It is indicated by FIC≤2 with the combined use of the EA and the IMP that the two drugs have no antagonistic effect, wherein 40% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the EA is smaller than or equal to the single-use MIC, the MIC₅₀of the IMP is reduced from single-use 32 μg/ml to 2 μg/ml and is reduced by 93.75%; and the MIC₉₀is reduced from 64 μg/ml to 16 μg/ml and is reduced by 75%.
It is indicated by FIC≤2 with the combined use of the EA and the LVX to the 20 MDRPAs that the two drugs have no antagonistic effect, wherein 15% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRPA, when the concentration of the EA is smaller than or equal to the single-use MIC, the MIC₅₀of the LVX is reduced from single-use 4 μg/ml to 1 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 32 μg/ml to 8 μg/ml and is reduced by 75%.
2.2. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 10% ethanol extract and the five antibiotics (the LVX, the IMP, the AMK, the CAZ and the CFP) to the MDRPAs are shown in table P13.
In-vitro bactericidal test results of the Pithecellobium clypearia Benth 10% ethanol extract to the MDRPAs are shown in table P14.
According to statistic analysis, the in-vitro inhibitory and bactericidal MBC₅₀and MBC₉₀of the Pithecellobium clypearia Benth 10% ethanol extract and the five antibiotics to the MDRPAs are shown in table P15.
According to statistic analysis, the bactericidal MBC₅₀and MBC₉₀of the EA to the MDRPAs are shown in table P16.
FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 10% ethanol extract and the five antibiotics and distribution statistical results of the FIC values are shown in table P17 and table P18.
The sensibilization effects of the Pithecellobium clypearia Benth 10% ethanol extract to the five antibiotics and the MIC₅₀and MIC₉₀after combined use are shown in tables P19-P24.

TABLE P13

In-vitro inhibitory test results of the Pithecellobium clypearia
Benth 10% ethanol extract and the five antibiotics to the MDRPAs

MIC(μg/ml)

Strain No.	EA	LVX	IMP	AMK	CAZ	CFP

P1	800	32	32	1	32	128
P2	800	4	64	1	64	256
P3	800	8	64	4	4	16
P4	800	8	32	1	256	8
P5	800	1	64	2	64	512
P6	800	0.5	32	256	512	512
P7	800	32	32	1	64	512
P8	1600	1	64	1	256	16
P9	800	4	32	1	8	64
P10	800	128	64	4	4	8
P11	800	2	8	1	2	8
P12	800	1	32	32	64	512
P13	800	2	8	2	16	256
P14	800	32	32	2	16	8
P15	800	2	32	2	256	64
P16	1600	32	16	256	32	>512
P17	800	4	16	1	32	16
P18	800	4	32	16	64	256
P19	800	16	64	1	4	64
P20	800	4	4	2	256	>512
ATCC27853	400	1	4	2	4	8

TABLE P14

In-vitro bactericidal test results of the Pithecellobium clypearia
Benth 10% ethanol extract to the MDRPAs

	Strain No.	MBC (μg/ml)

	P1	1600
	P2	1600
	P3	1600
	P4	1600
	P5	1600
	P6	1600
	P7	1600
	P8	1600
	P9	1600
	P10	1600
	P11	1600
	P12	1600
	P13	1600
	P14	1600
	P15	1600
	P16	1600
	P17	1600
	P18	1600
	P19	3200
	P20	1600

TABLE P15

Statistical results on in-vitro inhibitory MIC₅₀and
MIC₉₀of the Pithecellobium clypearia Benth 10%
ethanol extract and the antibiotics to the MDRPAs

MIC (μg/ml)

	Drug	Range	MIC₅₀	MIC₉₀

EA	800-1600	800	800
CAZ	2-512	32	256
CFP	8-512	64	512
AMK	1-256	1	32
IMP	4-64	32	64
LVX	0.5-128	4	32

TABLE P16

Bactericidal MBC₅₀and MBC₉₀of the Pithecellobium clypearia
Benth 10% ethanol extract to the MDRPAs

MBC (μg/ml)

Drug	Range	MBC₅₀	MBC₉₀

EA	1600-3200	1600	1600

TABLE P17

FIC values of the combined drug sensitive test of the Pithecellobium
clypearia Benth 10% ethanol extract and the five antibiotics

Strain

FIC

No.	EA + CAZ	EA + CFP	EA + AMK	EA + IMP	EA + LVX

P1	0.75	0.5	0.5625	0.75	0.625
P2	0.5	1	0.3125	0.28125	0.507813
P3	0.75	0.375	0.75	0.28125	0.503906
P4	0.5	1	1.5	1	1
P5	0.75	1	1.03125	0.5	0.53125
P6	0.75	0.625	0.75	0.5625	0.3125
P7	0.75	0.515625	0.5625	0.5625	1.000977
P8	0.375	0.15625	0.75	0.28125	0.28125
P9	1	1	0.5625	1	1
P10	0.75	0.75	0.5	0.5	0.75
P11	1	0.75	0.75	0.75	1
P12	0.53125	0.253906	0.5	0.5625	1
P13	0.5	0.375	0.28125	0.5	1
P14	1	0.53125	0.53125	0.625	0.5625
P15	1	0.375	0.53125	0.375	1
P16	0.5	0.375	0.257813	0.375	0.375
P17	0.5	0.53125	0.5625	0.625	1
P18	1	1	0.5	0.375	1.5
P19	1	0.507813	0.5625	0.375	0.75
P20	0.5	0.500977	50.5	1	0.75

TABLE 18

Distribution statistical results of the FIC values of the
combined drug sensitive test of the Pithecellobium clypearia
Benth 10% ethanol extract and the five antibiotics

	EA +	EA +	EA +	EA +	EA +
FIC Range	CAZ	CFP	AMK	IMP	LVX

FIC ≤ 0.5	35%	35%	30%	50%	15%
0.5 < FIC ≤ 1	65%	65%	55%	50%	75%
1 < FIC ≤ 2	—	—	15%	—	10%
FIC > 2	—	—	—	—	—

TABLE P19

Sensibilization effect of the Pithecellobium clypearia Benth
10% ethanol extract to the CAZ and MIC after combined use

P1	800	200	32	16
P2	800	200	64	16
P3	800	200	4	2
P4	800	200	256	64
P5	800	200	64	32
P6	800	200	512	256
P7	800	200	64	32
P8	1600	200	256	64
P9	800	400	8	4
P10	800	200	4	2
P11	800	400	2	1
P12	800	400	64	2
P13	800	200	16	4
P14	800	400	16	8
P15	800	400	256	128
P16	1600	400	32	8
P17	800	200	32	8
P18	800	400	64	32
P19	800	400	4	2
P20	800	200	256	64

TABLE P20

Sensibilization effect of the Pithecellobium clypearia Benth
10% ethanol extract to the CFP and MIC after combined use

P1	800	200	128	32
P2	800	400	256	128
P3	800	200	16	2
P4	800	400	8	4
P5	800	400	512	256
P6	1600	200	512	256
P7	800	400	512	8
P8	1600	200	16	0.5
P9	800	400	64	32
P10	800	400	8	2
P11	800	200	8	4
P12	800	200	512	2
P13	800	200	256	32
P14	800	400	8	0.25
P15	800	200	64	8
P16	1600	200	1024	256
P17	800	400	16	0.5
P18	800	400	256	128
P19	800	400	64	0.5
P20	800	400	1024	1

TABLE P21

Sensibilization effect of the Pithecellobium clypearia Benth
10% ethanol extract to the AMK and MIC after combined use

P1	800	400	1	0.0625
P2	800	200	1	0.0625
P3	800	200	4	2
P4	800	800	1	0.5
P5	800	800	2	0.0625
P6	1600	800	256	64
P7	800	400	1	0.0625
P8	1600	400	1	0.5
P9	800	400	1	0.0625
P10	800	200	4	1
P11	800	400	1	0.25
P12	800	200	32	8
P13	800	200	2	0.0625
P14	800	400	2	0.0625
P15	800	400	2	0.0625
P16	1600	400	256	2
P17	800	400	1	0.0625
P18	800	200	16	4
P19	800	400	1	0.0625
P20	800	40000	2	1

TABLE P22

Sensibilization effect of the Pithecellobium clypearia Benth
10% ethanol extract to the IMP and MIC after combined use

P1	800	200	32	16
P2	800	200	64	2
P3	800	200	64	2
P4	800	400	32	16
P5	800	200	64	16
P6	1600	800	32	2
P7	800	400	32	2
P8	1600	400	64	2
P9	800	400	32	16
P10	800	200	64	16
P11	800	200	8	4
P12	800	400	32	2
P13	800	200	8	2
P14	800	400	32	4
P15	800	200	32	4
P16	1600	400	16	2
P17	800	400	16	2
P18	800	200	32	4
P19	800	200	64	8
P20	800	400	4	2

TABLE P23

Sensibilization effect of the Pithecellobium clypearia Benth
10% ethanol extract to the LVX and MIC after combined use

P1	800	400	32	4
P2	800	400	4	0.03125
P3	800	400	8	0.03125
P4	800	400	8	4
P5	800	400	1	0.03125
P6	1600	400	0.5	0.03125
P7	800	800	32	0.03125
P8	1600	400	1	0.03125
P9	800	400	4	2
P10	800	400	128	32
P11	800	400	2	1
P12	800	400	1	0.5
P13	800	400	2	1
P14	800	400	32	2
P15	800	400	2	1
P16	1600	400	32	4
P17	800	400	4	2
P18	800	400	4	4
P19	800	400	16	4
P20	800	400	4	1

TABLE P24

MIC₅₀and MIC₉₀of the five antibiotics after combined use

Antibiotic (μg/ml)

Combined drug	MIC₅₀after combined use	MIC₉₀after combined use

EA + CAZ	16	64
EA + CFP	4	256
EA + AMK	0.0625	4
EA + IMP	2	16
EA + LVX	1	4

With the single use of the Pithecellobium clypearia Benth 10% ethanol extract to the MDRPA, the MIC₅₀is 800 μg/ml, the MIC₉₀is 1600 μg/ml, the MBC₅₀is 1600 μg/ml, and the MBC₉₀is 1600 μg/ml.
For the 20 MDRPAs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the CAZ that the two drugs have no antagonistic effect, wherein 35% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the CAZ is reduced from single-use 32 μg/ml to 16 μg/ml and is reduced by 50%; and the MIC₉₀is reduced from 256 μg/ml to 64 μg/ml and is reduced by 75%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the CFP to the 20 MDRPAs that the two drugs have no antagonistic effect, wherein 35% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the CFP is reduced from single-use 64 μg/ml to 4 μg/ml and is reduced by 93.75%; and the MIC₉₀is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the AMK that the two drugs have no antagonistic effect, wherein 30% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the AMK is reduced from single-use 1 μg/ml to 0.0625 μg/ml and is reduced by 93.75%; and the MIC₉₀is reduced from 32 μg/ml to 4 μg/ml and is reduced by 87.5%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the IMP that the two drugs have no antagonistic effect, wherein 50% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the IMP is reduced from single-use 32 μg/ml to 2 μg/ml and is reduced by 93.75%; and the MIC₉₀is reduced from 64 μg/ml to 16 μg/ml and is reduced by 75%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the LVX to the 20 MDRPAs that the two drugs have no antagonistic effect, wherein 15% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRPA, when the concentration of the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the LVX is reduced from single-use 4 μg/ml to 1 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 32 μg/ml to 4 μg/ml and is reduced by 87.5%.
2.3. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 60% ethanol extract and the five antibiotics (the LVX, the IMP, the AMK, the CAZ and the CFP) to the MDRPAs are shown in table P25.
In-vitro bactericidal test results of the Pithecellobium clypearia Benth 60% ethanol extract to the MDRPAs are shown in table P26.
The statistic analysis on in-vitro inhibitory and bactericidal MIC₅₀and MIC₉₀of the Pithecellobium clypearia Benth 60% ethanol extract and the five antibiotics to the MDRPAs is shown in table P27.
The statistic analysis on bactericidal MBC₅₀and MBC₉₀of the EA to the MDRPAs is shown in table P28.
FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 60% ethanol extract and the five antibiotics and distribution statistical results of the FIC values are shown in table P29 and table P30.
The sensibilization effects of the Pithecellobium clypearia Benth 60% ethanol extract to the five antibiotics and the MIC₅₀and MIC₉₀after combined use are shown in tables P31-P36.

TABLE P25

In-vitro inhibitory test results of the Pithecellobium clypearia
Benth 60% ethanol extract and the five antibiotics to the MDRPAs

MIC(μg/ml)

Strain No.	EA	LVX	IMP	AMK	CAZ	CFP

P1	400	32	32	1	32	128
P2	200	4	64	1	64	256
P3	400	8	64	4	4	16
P4	400	8	32	1	256	8
P5	400	1	64	2	64	512
P6	400	0.5	32	256	512	512
P7	400	32	32	1	64	512
P8	800	1	64	1	256	16
P9	400	4	32	1	8	64
P10	400	128	64	4	4	8
P11	400	2	8	1	2	8
P12	400	1	32	32	64	512
P13	400	2	8	2	16	256
P14	800	32	32	2	16	8
P15	400	2	32	2	256	64
P16	800	32	16	256	32	>512
P17	400	4	16	1	32	16
P18	400	4	32	16	64	256
P19	800	16	64	1	4	64
P20	800	4	4	2	256	>512
ATCC27853	400	1	4	2	4	8

TABLE P26

In-vitro bactericidal test results of the Pithecellobium clypearia
Benth 60% ethanol extract to the MDRPAs

	Strain No.	MBC (μg/ml)

	P1	400
	P2	400
	P3	800
	P4	800
	P5	800
	P6	800
	P7	800
	P8	800
	P9	1600
	P10	1600
	P11	1600
	P12	1600
	P13	1600
	P14	1600
	P15	1600
	P16	1600
	P17	1600
	P18	1600
	P19	1600
	P20	1600

TABLE P27

Statistical results on in-vitro inhibitory MIC₅₀and
MIC₉₀of the Pithecellobium clypearia Benth 60% ethanol
extract and the five antibiotics to the MDRPAs

MIC (μg/ml)

	Drug	Range	MIC₅₀	MIC₉₀

EA	200-800	400	800
CAZ	2-512	32	256
CFP	8-512	64	512
AMK	1-256	1	32
IMP	4-64	32	64
LVX	0.5-128	4	32

TABLE P28

Bactericidal MBC₅₀and MBC₉₀of the Pithecellobium clypearia
Benth 60% ethanol extract to the MDRPAs

MBC (μg/ml)

Drug	Range	MBC₅₀	MBC₉₀

EA	400-1600	1600	1600

TABLE P29

FIC values of the combined drug sensitive test of the Pithecellobium
clypearia Benth 60% ethanol extract and the five antibiotics

Strain

FIC

No.	EA + CAZ	EA + CFP	EA + AMK	EA + IMP	EA + LVX

P1	0.375	0.375	1.0625	0.625	0.25
P2	0.625	0.75	0.5625	0.53125	0.5078
P3	1.125	1.03125	0.5	0.15625	1.0039
P4	0.375	1.0625	1.5	1.0625	1
P5	1.0078	0.625	1.03125	0.75	1.03125
P6	0.75	1	1.125	1.0625	1.0625
P7	1	0.625	1.0625	1.0625	1.0010
P8	0.3125	0.53125	0.5625	0.53125	0.53125
P9	1.0625	0.625	0.5625	0.75	1
P10	1.125	1.0625	0.375	0.75	0.5
P11	1.25	1.0625	0.75	1.25	2.0625
P12	0.5078	0.5010	0.375	0.5625	1.5
P13	0.75	0.375	0.53125	0.5	1.015625
P14	0.375	0.5625	0.53125	0.5	1.03125
P15	0.75	0.375	1.03125	0.75	2.5
P16	0.375	0.3125	0.5002	0.625	0.53125
P17	0.5	1.03125	1.0625	1.125	3
P18	0.5	0.625	0.375	1.0625	2.0625
P19	0.625	0.5078	0.5625	0.53125	0.625
P20	0.3125	0.5005	0.5625	0.625	0.625

TABLE P30

Distribution statistical results of the FIC values of the
combined drug sensitive test of the Pithecellobium clypearia
Benth 60% ethanol extract and the five antibiotics

	EA +	EA +	EA +	EA +	EA +
FIC Range	CAZ	CFP	AMK	IMP	LVX

FIC ≤ 0.5	40%	20%	20%	15%	10%
0.5 < FIC ≤ 1	35%	55%	45%	55%	35%
1 < FIC ≤ 2	25%	25%	35%	30%	35%
FIC > 2	—	—	—	—	20%

TABLE P31

Sensibilization effect of the Pithecellobium clypearia Benth
60% ethanol extract to the CAZ and MIC after combined use

P1	400	50	32	8
P2	200	100	64	8
P3	400	50	4	4
P4	400	50	256	64
P5	400	400	64	0.5
P6	400	100	512	256
P7	400	200	64	32
P8	800	50	256	64
P9	400	400	8	0.5
P10	400	400	4	0.5
P11	400	400	2	0.5
P12	400	200	64	0.5
P13	400	100	16	8
P14	800	100	16	4
P15	400	100	256	128
P16	800	100	32	8
P17	400	100	32	8
P18	400	100	64	16
P19	800	400	4	0.5
P20	800	50	256	64

TABLE P32

Sensibilization effect of the Pithecellobium clypearia Benth
60% ethanol extract to the CFP and MIC after combined use

P1	400	50	128	32
P2	200	50	256	128
P3	400	400	16	0.5
P4	400	400	8	0.5
P5	400	50	512	256
P6	400	200	512	256
P7	400	50	512	256
P8	800	400	16	0.5
P9	400	50	64	32
P10	400	400	8	0.5
P11	400	400	8	0.5
P12	400	200	512	0.5
P13	400	100	256	32
P14	800	400	8	0.5
P15	400	50	64	16
P16	800	50	1024	256
P17	400	400	16	0.5
P18	400	50	256	128
P19	800	400	64	0.5
P20	800	400	1024	0.5

TABLE P33

Sensibilization effect of the Pithecellobium clypearia Benth
60% ethanol extract to the AMK and MIC after combined use

P1	400	400	1	0.0625
P2	200	100	1	0.0625
P3	400	100	4	1
P4	400	400	1	0.5
P5	400	400	2	0.0625
P6	400	400	256	32
P7	400	400	1	0.0625
P8	800	50	1	0.5
P9	400	200	1	0.0625
P10	400	50	4	1
P11	400	100	1	0.5
P12	400	50	32	8
P13	400	200	2	0.0625
P14	800	400	2	0.0625
P15	400	400	2	0.0625
P16	800	400	256	0.0625
P17	400	400	1	0.0625
P18	400	100	16	2
P19	800	400	1	0.0625
P20	800	50	2	1

TABLE P34

Sensibilization effect of the Pithecellobium clypearia Benth
60% ethanol extract to the IMP and MIC after combined use

P1	400	50	32	16
P2	200	100	64	2
P3	400	50	64	2
P4	400	400	32	2
P5	400	200	64	16
P6	400	400	32	2
P7	400	400	32	2
P8	800	400	64	2
P9	400	100	32	16
P10	400	200	64	16
P11	400	400	8	2
P12	400	200	32	2
P13	400	100	8	2
P14	800	200	32	8
P15	400	200	32	8
P16	800	400	16	2
P17	400	400	16	2
P18	400	400	32	2
P19	800	400	64	2
P20	800	100	4	2

TABLE P35

Sensibilization effect of the Pithecellobium clypearia Benth
60% ethanol extract to the LVX and MIC after combined use

P1	400	50	32	4
P2	200	100	4	0.03125
P3	400	400	8	0.03125
P4	400	200	8	4
P5	400	400	1	0.03125
P6	400	400	0.5	0.03125
P7	400	400	32	0.03125
P8	800	400	1	0.03125
P9	400	200	4	2
P10	400	100	128	32
P11	400	25	2	4
P12	400	400	1	0.5
P13	400	400	2	0.03125
P14	800	800	32	1
P15	400	800	2	1
P16	800	25	32	16
P17	400	800	4	4
P18	400	25	4	8
P19	800	100	16	8
P20	800	100	4	2

TABLE P36

MIC₅₀and MIC₉₀of the five antibiotics after combined use

Antibiotic (μg/ml)

Combined drug	MIC₅₀after combined use	MIC₉₀after combined use

EA + CAZ	8	64
EA + CFP	4	256
EA + AMK	0.0625	4
EA + IMP	2	16
EA + LVX	1	8

With the single use of the Pithecellobium clypearia Benth 60% ethanol extract to the MDRPA, the MIC₅₀is 800 μg/ml, the MIC₉₀is 1600 μg/ml, the MBC₅₀is 1600 μg/ml, and the MBC₉₀is 1600 μg/ml.
For the 20 MDRPAs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the CAZ that the two drugs have no antagonistic effect, wherein 40% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the CAZ is reduced from single-use 32 μg/ml to 8 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 256 μg/ml to 64 μg/ml and is reduced by 75%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the CFP to the 20 MDRPAs that the two drugs have no antagonistic effect, wherein 20% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the CFP is reduced from single-use 64 μg/ml to 4 μg/ml and is reduced by 93.75%; and the MIC₉₀is reduced from 512 μg/ml to 256 μg/ml and is reduced by 50%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the AMK that the two drugs have no antagonistic effect, wherein 20% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the AMK is reduced from single-use 1 μg/ml to 0.0625 μg/ml and is reduced by 93.75%; and the MIC₉₀is reduced from 32 μg/ml to 2 μg/ml and is reduced by 93.75%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the IMP that the two drugs have no antagonistic effect, wherein 15% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the IMP is reduced from single-use 32 μg/ml to 2 μg/ml and is reduced by 93.75%; and the MIC₉₀is reduced from 64 μg/ml to 16 μg/ml and is reduced by 75%.
With the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the LVX to the 20 MDRPAs, there are four strains with FIC greater than 2 and has the antagonistic effect, wherein 10% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRPA, when the concentration of the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the LVX is reduced from single-use 4 μg/ml to 1 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 32 μg/ml to 8 μg/ml and is reduced by 75%.
2.4. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 95% ethanol extract and the five antibiotics (the LVX, the IMP, the AMK, the CAZ and the CFP) to the MDRPAs are shown in table P37.
In-vitro bactericidal test results of the Pithecellobium clypearia Benth 95% ethanol extract to the MDRPAs are shown in table P38.
The statistic analysis on in-vitro inhibitory and bactericidal MIC₅₀and MIC₉₀of the Pithecellobium clypearia Benth 95% ethanol extract and the five antibiotics to the MDRPAs is shown in table P39.
The statistic analysis on bactericidal MBC₅₀and MBC₉₀of the Pithecellobium clypearia Benth 95% ethanol extract to the MDRPAs is shown in table P40.
FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 95% ethanol extract and the five antibiotics and distribution statistical results of the FIC values are shown in table P41 and table P42.
The sensibilization effects of the Pithecellobium clypearia Benth 95% ethanol extract to the five antibiotics and the MIC₅₀and MIC₉₀after combined use are shown in tables P43-P48.

TABLE P37

In-vitro inhibitory test results of the Pithecellobium clypearia
Benth 95% ethanol extract and the five antibiotics to the MDRPAs

MIC(μg/ml)

Strain No.	EA	LVX	IMP	AMK	CAZ	CFP

P1	800	32	32	1	32	128
P2	800	4	64	1	64	256
P3	800	8	64	4	4	16
P4	800	8	32	1	256	8
P5	800	1	64	2	64	512
P6	800	0.5	32	256	512	512
P7	800	32	32	1	64	512
P8	800	1	64	1	256	16
P9	800	4	32	1	8	64
P10	800	128	64	4	4	8
P11	800	2	8	1	2	8
P12	800	1	32	32	64	512
P13	800	2	8	2	16	256
P14	800	32	32	2	16	8
P15	800	2	32	2	256	64
P16	800	32	16	256	32	>512
P17	800	4	16	1	32	16
P18	800	4	32	16	64	256
P19	800	16	64	1	4	64
P20	800	4	4	2	256	>512
ATCC27853	400	1	4	2	4	8

TABLE P38

In-vitro bactericidal test results of the Pithecellobium clypearia
Benth 95% ethanol extract to the MDRPAs

	Strain No.	MBC (μg/ml)

	P1	1600
	P2	1600
	P3	1600
	P4	1600
	P5	1600
	P6	1600
	P7	1600
	P8	1600
	P9	1600
	P10	1600
	P11	1600
	P12	1600
	P13	1600
	P14	1600
	P15	1600
	P16	3200
	P17	1600
	P18	1600
	P19	1600
	P20	1600

TABLE P39

Statistical results on in-vitro inhibitory MIC₅₀and
MIC₉₀of the Pithecellobium clypearia Benth 95% ethanol
extract and the five antibiotics to the MDRPAs

MIC (μg/ml)

	Drug	Range	MIC₅₀	MIC₉₀

EA	800	800	800
CAZ	2-512	32	256
CFP	8-512	64	512
AMK	1-256	1	32
IMP	4-64	32	64
LVX	0.5-128	4	32

TABLE P40

Bactericidal MBC₅₀and MBC₉₀of the Pithecellobium clypearia
Benth 95% ethanol extract to the MDRPAs

MBC (μg/ml)

Drug	Range	MBC₅₀	MBC₉₀

EA	1600-3200	1600	1600

TABLE P41

FIC values of the combined drug sensitive test of the Pithecellobium
clypearia Benth 95% ethanol extract and the five antibiotics

Strain

FIC

No.	EA + CAZ	EA + CFP	EA + AMK	EA + IMP	EA + LVX

P1	1	0.5	0.5625	1	0.625
P2	0.75	1	0.3125	0.3125	0.507813
P3	0.75	0.5	1	0.3125	0.503906
P4	1	1	1.5	0.75	1
P5	1	1	1.03125	0.375	1.03125
P6	1	0.75	1.125	0.5625	1.0625
P7	0.75	0.515625	0.37	0.5625	1.000977
P8	0.5	0.28125	0.75	0.5	0.53125
P9	1	1	0.3125	1	1
P10	1	0.375	0.5	0.5	0.75
P11	1	1	1	0.75	1
P12	0.53125	0.503906	0.5	0.5625	1
P13	0.5	0.375	0.28125	0.75	1
P14	1	0.53125	0.53125	0.625	0.3125
P15	1	0.375	0.28125	0.375	1
P16	0.375	0.5	0.507813	0.625	0.625
P17	0.375	0.53125	0.5625	0.625	1
P18	1	0.75	0.5	0.375	1.5
P19	0.75	0.28125	0.5625	0.375	0.5
P20	0.5	0.500977	1	1	0.75

TABLE P42

Distribution statistical results of the FIC values of the
combined drug sensitive test of the Pithecellobium clypearia
Benth 95% ethanol extract and the five antibiotics

	EA +	EA +	EA +	EA +	EA +
FIC Strain No.	CAZ	CFP	AMK	IMP	LVX

FIC ≤ 0.5	25%	40%	40%	40%	10%
0.5 < FIC ≤ 1	75%	60%	45%	60%	70%
1 < FIC ≤ 2	—	—	15%	—	20%
FIC > 2	—	—	—	—	—

TABLE P43

Sensibilization effect of the Pithecellobium clypearia Benth
95% ethanol extract to the CAZ and MIC after combined use

P1	800	400	32	16
P2	800	400	64	16
P3	800	400	4	1
P4	800	400	256	128
P5	800	400	64	32
P6	800	400	512	256
P7	800	200	64	32
P8	800	200	256	64
P9	800	400	8	4
P10	800	400	4	2
P11	800	400	2	1
P12	800	400	64	2
P13	800	200	16	4
P14	800	400	16	8
P15	800	400	256	128
P16	800	200	32	4
P17	800	200	32	4
P18	800	400	64	32
P19	800	400	4	1
P20	800	200	256	64

TABLE P44

Sensibilization effect of the Pithecellobium clypearia Benth
95% ethanol extract to the CFP and MIC after combined use

P1	800	200	128	32
P2	800	400	256	128
P3	800	200	16	4
P4	800	400	8	4
P5	800	400	512	256
P6	800	400	512	128
P7	800	400	512	8
P8	800	200	16	0.5
P9	800	400	64	32
P10	800	200	8	1
P11	800	400	8	4
P12	800	400	512	2
P13	800	200	256	32
P14	800	400	8	0.25
P15	800	200	64	8
P16	800	200	1024	256
P17	800	400	16	0.5
P18	800	200	256	128
P19	800	200	64	2
P20	800	400	1024	1

TABLE P45

Sensibilization effect of the Pithecellobium clypearia Benth
95% ethanol extract to the AMK and MIC after combined use

P1	800	400	1	0.0625
P2	800	200	1	0.0625
P3	800	400	4	2
P4	800	800	1	0.5
P5	800	800	2	0.0625
P6	800	800	256	32
P7	800	200	1	0.12
P8	800	200	1	0.5
P9	800	200	1	0.0625
P10	800	200	4	1
P11	800	400	1	0.5
P12	800	200	32	8
P13	800	200	2	0.0625
P14	800	400	2	0.0625
P15	800	200	2	0.0625
P16	800	400	256	2
P17	800	400	1	0.0625
P18	800	200	16	4
P19	800	400	1	0.0625
P20	800	400	2	1

TABLE P46

Sensibilization effect of the Pithecellobium clypearia Benth
95% ethanol extract to the IMP and MIC after combined use

P1	800	400	32	16
P2	800	200	64	4
P3	800	200	64	4
P4	800	400	32	8
P5	800	200	64	8
P6	800	400	32	2
P7	800	400	32	2
P8	800	200	64	16
P9	800	400	32	16
P10	800	200	64	16
P11	800	200	8	4
P12	800	400	32	2
P13	800	400	8	2
P14	800	400	32	4
P15	800	200	32	4
P16	800	400	16	2
P17	800	400	16	2
P18	800	200	32	4
P19	800	200	64	8
P20	800	400	4	2

TABLE P47

Sensibilization effect of the Pithecellobium clypearia Benth
95% ethanol extract to the LVX and MIC after combined use

P1	800	400	32	4
P2	800	400	4	0.03125
P3	800	400	8	0.03125
P4	800	400	8	4
P5	800	800	1	0.03125
P6	800	800	0.5	0.03125
P7	800	800	32	0.03125
P8	800	400	1	0.03125
P9	800	400	4	2
P10	800	400	128	32
P11	800	400	2	1
P12	800	400	1	0.5
P13	800	400	2	1
P14	800	200	32	2
P15	800	400	2	1
P16	800	400	32	4
P17	800	400	4	2
P18	800	400	4	4
P19	800	200	16	4
P20	800	400	4	1

TABLE P48

MIC₅₀and MIC₉₀of the five antibiotics after combined use

Antibiotic (μg/ml)

Combined drug	MIC₅₀after combined use	MIC₉₀after combined use

EA + CAZ	16	128
EA + CFP	4	128
EA + AMK	0.12	4
EA + IMP	4	16
EA + LVX	1	4

With the single use of the Pithecellobium clypearia Benth 95% ethanol extract to the MDRPA, the MIC₅₀is 800 μg/ml, the MIC₉₀is 800 μg/ml, the MBC₅₀is 1600 μg/ml, and the MBC₉₀is 1600 μg/ml.
For the 20 MDRPAs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the CAZ that the two drugs have no antagonistic effect, wherein 25% with FIC≤0.5 have the synergistic effect.
For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the CAZ is reduced from single-use 32 μg/ml to 16 μg/ml and is reduced by 50%; and the MIC₉₀is reduced from 256 μg/ml to 128 μg/ml and is reduced by 50%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the CFP to the 20 MDRPAs that the two drugs have no antagonistic effect, wherein 40% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the CFP is reduced from single-use 64 μg/ml to 4 μg/ml and is reduced by 93.75%; and the MIC₉₀is reduced from 512 μg/ml to 128 μg/ml and is reduced by 75%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the AMK that the two drugs have no antagonistic effect, wherein 40% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the AMK is reduced from single-use 1 μg/ml to 0.12 μg/ml and is reduced by 87.5%; and the MIC₉₀is reduced from 32 μg/ml to 4 μg/ml and is reduced by 87.5%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the IMP that the two drugs have no antagonistic effect, wherein 40% with FIC≤0.5 have the synergistic effect. For the 20 MDRPAs, when the concentration of the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the IMP is reduced from single-use 32 μg/ml to 4 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 64 μg/ml to 16 μg/ml and is reduced by 75%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the LVX to the 20 MDRPAs that the two drugs have no antagonistic effect, wherein 10% with FIC≤0.5 show that the two drugs have a certain synergistic effect. For the 20 MDRPA, when the concentration of the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀of the LVX is reduced from single-use 4 μg/ml to 1 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 32 μg/ml to 4 μg/ml and is reduced by 87.5%.
III. Inhibitory and Bactericidal Tests of the ESBL-Producing Escherichia coli (Hereinafter Referred to as an ESBL-Producing ECO) Resistance of the EA and Test of the Sensibilization Effect by Respectively Using with the AMK or the SXT

Embodiment 3

1. Test Method: The MDRPA (Serial No.: E1-E20) Strains are Tested and are Evaluated with Reference to the Method in the First Embodiment.
2. Test Results
2.1. In-vitro inhibitory test results of the Pithecellobium clypearia Benth water extract and the two antibiotics (the AMK and the SXT) to the ESBL-producing ECOs are shown in table E1.
In-vitro bactericidal test results of the Pithecellobium clypearia Benth water extract to the ESBL-producing ECOs are shown in table E2.
The statistic analysis on in-vitro inhibitory and bactericidal MIC₅₀and MIC₉₀of the Pithecellobium clypearia Benth water extract and the two antibiotics to the ESBL-producing ECOs is shown in table E3.
The statistic analysis on bactericidal MBC₅₀and MBC₉₀of the EA to the ESBL-producing ECOs is shown in table E4.
FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth water extract and the two antibiotics and distribution statistical results of the FIC values are shown in table E5 and table E6.
The sensibilization effects of the Pithecellobium clypearia Benth water extract to the two antibiotics and the MIC₅₀and MIC₉₀after combined use are shown in tables E7-E9

	TABLE E1

	MIC (μg/ml)

	Strain No.	EA	AMK	SXT

E1	1600	4	2432/128
E2	1600	16	2432/128
E3	1600	512	2432/128
E4	1600	4	76/4
E5	1600	16	2432/128
E6	1600	4	2432/128
E7	1600	32	2432/128
E8	1600	32	2432/128
E9	1600	64	2432/128
E10	1600	8	2432/128
E11	1600	32	76/4
E12	1600	32	2432/128
E13	1600	4	2432/128
E14	1600	8	2432/128
E15	1600	8	2432/128
E16	1600	16	2432/128
E17	1600	8	2432/128
E18	1600	128	2432/128
E19	1600	64	152/8
E20	1600	16	76/4
ATCC25922	800	4	9.5/0.5

	TABLE E2

	Strain No.	MBC(μg/ml)

	E1	3200
	E2	3200
	E3	3200
	E4	3200
	E5	3200
	E6	3200
	E7	3200
	E8	3200
	E9	3200
	E10	3200
	E11	3200
	E12	3200
	E13	3200
	E14	3200
	E15	3200
	E16	3200
	E17	3200
	E18	3200
	E19	3200
	E20	3200

	TABLE E3

	MIC (μg/ml)

	Drug	Range	MIC₅₀	MIC₉₀

EA	1600	1600	1600
AMK	4-512	16	64
SXT	76/4-2432/128	2432/128	2432/128

	TABLE E4

	MBC (μg/ml)

Drug	Range	MBC₅₀	MBC₉₀

EA	3200	3200	3200

	TABLE E5

	FIC

	Strain No.	EA + AMK	EA + SXT

E1	0.75	0.507813
E2	0.375	1.003906
E3	0.28125	0.507813
E4	0.75	0.75
E5	0.625	0.507813
E6	1	0.515625
E7	0.375	0.507813
E8	0.5	0.507813
E9	0.375	0.500061
E10	0.75	0.507813
E11	0.5	0.375
E12	0.75	0.125485
E13	1.25	0.507813
E14	0.75	0.507813
E15	0.75	0.500058
E16	0.5	0.125485
E17	0.5	0.507813
E18	0.625	0.250977
E19	0.375	0.375
E20	0.5	0.75

TABLE E6

FIC Range	EA + AMK	EA + SXT

FIC ≤ 0.5	50%	25%
0.5 < FIC ≤ 1	45%	70%
1 < FIC ≤ 2	5%	5%
FIC > 2	—	—

TABLE E7

	EA	EA	AMK	AMK
Strain	single-use	combined-use	single-use	combined-use
No.	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)

E1	1600	400	4	2
E2	1600	200	16	4
E3	1600	400	512	16
E4	1600	400	4	2
E5	1600	200	16	8
E6	1600	800	4	2
E7	1600	200	32	8
E8	1600	400	32	8
E9	1600	400	64	8
E10	1600	400	8	4
E11	1600	400	32	8
E12	1600	400	32	16
E13	1600	800	4	2
E14	1600	400	8	4
E15	1600	400	8	4
E16	1600	400	16	4
E17	1600	400	8	2
E18	1600	800	128	16
E19	1600	200	64	16
E20	1600	400	16	4

TABLE E8

	EA	EA	SXT	SXT
Strain	single-use	combined-use	single-use	combined-use
No.	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)

E1	1600	800	2432/128	19/1
E2	1600	1600	2432/128	9.5/0.5
E3	1600	800	2432/128	19/1
E4	1600	800	76/4	19/1
E5	1600	800	2432/128	19/1
E6	1600	800	2432/128	38/2
E7	1600	800	2432/128	19/1
E8	1600	800	2432/128	19/1
E9	1600	800	2432/128	0.148438/0.078125
E10	1600	800	2432/128	19/1
E11	1600	200	76/4	19/1
E12	1600	200	2432/128	1.1875/0.0625
E13	1600	800	2432/128	19/1
E14	1600	800	2432/128	19/1
E15	1600	800	2432/128	0.148438/0.078125
E16	1600	200	2432/128	1.1875/0.0625
E17	1600	800	2432/128	19/1
E18	1600	400	2432/128	2.375/0.125
E19	1600	400	152/8	19/1
E20	1600	800	76/4	19/1

	TABLE E9

	Antibiotic (μg/ml)

Combined drug	MIC₅₀after combined use	MIC₉₀after combined use

EA + AMK	4	16
EA + SXT	19/1	19/1

The test results shows that, with the single use of the Pithecellobium clypearia Benth water extract to the ESBL-producing ECOs, the MIC₅₀is 1600 μg/ml, the MIC₉₀is 1600 μg/ml, the MBC₅₀is 3200 μg/ml, and the MBC₉₀is 3200 μg/ml.
For the 20 ESBL-producing ECOs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth water extract and the AMK that the two drugs have no antagonistic effect, wherein 50% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth water extract is smaller than or equal to ½ MIC, the MIC₅₀of the AMK is reduced from single-use 16 μg/ml to 4 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 64 μg/ml to 16 μg/ml and is reduced by 75%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth water extract and the SXT to the 20 ESBL-producing ECOs that the two drugs have no antagonistic effect, wherein 25% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth water extract is smaller than or equal to the single-use MIC, the MIC₅₀and the MIC₉₀of the SXT are respectively reduced from single-use 2432/128 μg/ml to 19/1 μg/ml, and are reduced by 99.3%.
2.2. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 10% ethanol extract and the two antibiotics (the AMK and the SXT) to the ESBL-producing ECOs are shown in table E10.
In-vitro bactericidal test results of the Pithecellobium clypearia Benth 10% ethanol extract to the ESBL-producing ECOs are shown in table E11.
The statistic analysis on in-vitro inhibitory and bactericidal MIC₅₀and MIC₉₀of the Pithecellobium clypearia Benth 10% ethanol extract and the two antibiotics to the ESBL-producing ECOs is shown in table E12.
The statistic analysis on bactericidal MBC₅₀and MBC₉₀of the Pithecellobium clypearia Benth 10% ethanol extract to the ESBL-producing ECOs is shown in table E13.
FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 10% ethanol extract and the two antibiotics and distribution statistical results of the FIC values are shown in table E14 and table E15.
The sensibilization effects of the Pithecellobium clypearia Benth 10% ethanol extract to the two antibiotics and the MIC₅₀and MIC₉₀after combined use are shown in tables E16-E18.

	TABLE E10

	MIC (μg/ml)

	Strain No.	EA	AMK	SXT

	TABLE E11

	Strain No.	MBC(μg/ml)

	E1	3200
	E2	3200
	E3	3200
	E4	3200
	E5	3200
	E6	3200
	E7	3200
	E8	3200
	E9	3200
	E10	3200
	E11	3200
	E12	3200
	E13	3200
	E14	3200
	E15	3200
	E16	3200
	E17	3200
	E18	3200
	E19	3200
	E20	3200

	TABLE E12

	MIC (μg/ml)

	Drug	Range	MIC₅₀	MIC₉₀

EA	1600	1600	1600
AMK	4-512	16	64
SXT	76/4-2432/128	2432/128	2432/128

	TABLE E13

	MBC (μg/ml)

Drug	Range	MBC₅₀	MBC₉₀

EA	3200	3200	3200

	TABLE E14

	FIC

	Strain No.	EA + AMK	EA + SXT

E1	1	0.507813
E2	0.75	0.507813
E3	0.265625	0.507813
E4	0.5	0.75
E5	0.5	0.507813
E6	1	0.507813
E7	0.5	0.507813
E8	0.75	0.507813
E9	0.5	0.500061
E10	0.75	0.507813
E11	0.5	0.5
E12	0.75	0.250975
E13	1	0.507813
E14	1	0.507813
E15	0.75	0.500058
E16	0.5	0.125485
E17	0.75	0.507813
E18	0.5	1.000977
E19	0.375	0.375
E20	0.5	0.75

TABLE E15

FIC Range	EA + AMK	EA + SXT

FIC ≤ 0.5	50%	20%
0.5 < FIC ≤ 1	50%	75%
1 < FIC ≤ 2	—	5%
FIC > 2	—	—

TABLE E16

	EA	EA	AMK	AMK
Strain	single-use	combined-use	single-use	combined-use
No.	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)

E1	1600	800	4	2
E2	1600	800	16	4
E3	1600	400	512	8
E4	1600	400	4	1
E5	1600	400	16	4
E6	1600	800	4	2
E7	1600	400	32	8
E8	1600	800	32	8
E9	1600	400	64	16
E10	1600	400	8	4
E11	1600	400	32	8
E12	1600	400	32	16
E13	1600	800	4	2
E14	1600	800	8	4
E15	1600	400	8	4
E16	1600	400	16	4
E17	1600	800	8	2
E18	1600	400	128	32
E19	1600	400	64	8
E20	1600	400	16	4

TABLE E17

	EA	EA	SXT	SXT
Strain	single-use	combined-use	single-use	combined-use
No.	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)

E1	1600	800	2432/128	19/1
E2	1600	800	2432/128	19/1
E3	1600	800	2432/128	19/1
E4	1600	800	76/4	19/1
E5	1600	800	2432/128	19/1
E6	1600	800	2432/128	19/1
E7	1600	800	2432/128	19/1
E8	1600	800	2432/128	19/1
E9	1600	800	2432/128	0.148438/0.078125
E10	1600	800	2432/128	19/1
E11	1600	400	76/4	19/1
E12	1600	400	2432/128	2.375/0.125
E13	1600	800	2432/128	19/1
E14	1600	800	2432/128	19/1
E15	1600	800	2432/128	0.148438/0.078125
E16	1600	200	2432/128	1.1875/0.0625
E17	1600	800	2432/128	19/1
E18	1600	1600	2432/128	2.375/0.125
E19	1600	400	152/8	19/1
E20	1600	800	76/4	19/1

	TABLE E18

	Antibiotic (μg/ml)

The test results shows that, with the single use of the Pithecellobium clypearia Benth 10% ethanol extract to the ESBL-producing ECOs, the MIC₅₀is 1600 μg/ml, the MIC₉₀is 1600 μg/ml, the MBC₅₀is 3200 μg/ml, and the MBC₉₀is 3200 μg/ml.
For the 20 ESBL-producing ECOs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the AMK that the two drugs have no antagonistic effect, wherein 50% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to ½ MIC, the MIC₅₀of the AMK is reduced from single-use 16 μg/ml to 4 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 64 μg/ml to 16 μg/ml and is reduced by 75%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 10% ethanol extract and the SXT to the 20 ESBL-producing ECOs that the two drugs have no antagonistic effect, wherein 20% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 10% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀and the MIC₉₀of the SXT are respectively reduced from single-use 2432/128 μg/ml to 19/1 μg/ml, and are reduced by 99.3%.
2.3. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 60% ethanol extract and the two antibiotics (the AMK and the SXT) to the ESBL-producing ECOs are shown in table E19.
In-vitro bactericidal test results of the Pithecellobium clypearia Benth 60% ethanol extract to the ESBL-producing ECOs are shown in table E20.
The statistic analysis on in-vitro inhibitory and bactericidal MIC₅₀and MIC₉₀of the Pithecellobium clypearia Benth 60% ethanol extract and the two antibiotics to the ESBL-producing ECOs is shown in table E21.
The statistic analysis on bactericidal MBC₅₀and MBC₉₀of the Pithecellobium clypearia Benth 60% ethanol extract to the ESBL-producing ECOs is shown in table E22.
FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 60% ethanol extract and the two antibiotics and distribution statistical results of the FIC values are shown in table E23 and table E24.
The sensibilization effects of the Pithecellobium clypearia Benth 60% ethanol extract to the two antibiotics and the MIC₅₀and MIC₉₀after combined use are shown in tables E25-E27.

	TABLE E19

	MIC (μg/ml)

	Strain No.	EA	AMK	SXT

E1	800	4	2432/128
E2	800	16	2432/128
E3	800	512	2432/128
E4	800	4	76/4
E5	800	16	2432/128
E6	1600	4	2432/128
E7	800	32	2432/128
E8	800	32	2432/128
E9	800	64	2432/128
E10	800	8	2432/128
E11	800	32	76/4
E12	800	32	2432/128
E13	400	4	2432/128
E14	800	8	2432/128
E15	800	8	2432/128
E16	800	16	2432/128
E17	800	8	2432/128
E18	800	128	2432/128
E19	800	64	152/8
E20	800	16	76/4
ATCC25922	800	4	9.5/0.5

	TABLE E20

	Strain No.	MBC(μg/ml)

	E1	1600
	E2	1600
	E3	1600
	E4	1600
	E5	1600
	E6	>1600
	E7	1600
	E8	1600
	E9	1600
	E10	1600
	E11	1600
	E12	1600
	E13	>1600
	E14	1600
	E15	1600
	E16	1600
	E17	1600
	E18	1600
	E19	1600
	E20	1600

	TABLE E21

	MIC (μg/ml)

	Drug	Range	MIC₅₀	MIC₉₀

EA	400-1600	800	800
AMK	4-512	16	64
SXT	76/4-2432/128	2432/128	2432/128

	TABLE E22

	MBC (μg/ml)

Drug	Range	MBC₅₀	MBC₉₀

EA	≥1600	1600	1600

	TABLE E23

	FIC

	Strain no.	EA + AMK	EA + SXT

E1	0.5625	1.0078
E2	0.25	1.0039
E3	0.2656	1.0001
E4	0.5625	0.75
E5	0.5625	0.5078
E6	0.375	0.2656
E7	0.125	0.5078
E8	0.1875	0.5078
E9	0.3125	1.0001
E10	0.5625	0.5078
E11	0.1875	0.0703
E12	0.1875	0.0630
E13	1.125	1.0039
E14	0.5625	0.5156
E15	0.3125	1.0001
E16	0.1875	0.0630
E17	0.3125	0.5078
E18	0.375	0.0635
E19	0.25	0.625
E20	0.3125	0.375

TABLE E24

FIC Range	EA + AMK	EA + SXT

FIC ≤ 0.5	70%	30%
0.5 < FIC ≤ 1	25%	40%
1 < FIC ≤ 2	5%	30%
FIC > 2	—	—

TABLE E25

	EA	EA	AMK	AMK
Strain	single-use	combined-use	single-use	combined-use
No.	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)

E1	800	50	4	2
E2	800	100	16	2
E3	800	200	512	8
E4	800	50	4	2
E5	800	50	16	8
E6	1600	400	4	0.5
E7	800	50	32	2
E8	800	50	32	4
E9	800	200	64	4
E10	800	50	8	4
E11	800	50	32	4
E12	800	50	32	4
E13	400	50	4	4
E14	800	50	8	4
E15	800	50	8	2
E16	800	50	16	2
E17	800	50	8	2
E18	800	100	128	32
E19	800	100	64	8
E20	800	50	16	4

TABLE E26

	EA	EA	SXT	SXT
Strain	single-use	combined-use	single-use	combined-use
No.	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)

E1	800	800	2432/128	19/1
E2	800	800	2432/128	9.5/0.5
E3	800	800	2432/128	0.148438/0.078125
E4	800	400	76/4	19/1
E5	800	400	2432/128	19/1
E6	1600	400	2432/128	38/2
E7	800	400	2432/128	19/1
E8	800	400	2432/128	19/1
E9	800	800	2432/128	0.148438/0.078125
E10	800	400	2432/128	19/1
E11	800	50	76/4	19/1
E12	800	50	2432/128	1.1875/0.0625
E13	400	400	2432/128	9.5/0.5
E14	800	400	2432/128	38/2
E15	800	800	2432/128	0.148438/0.078125
E16	800	50	2432/128	1.1875/0.0625
E17	800	400	2432/128	19/1
E18	800	50	2432/128	2.375/0.125
E19	800	400	152/8	19/1
E20	800	100	76/4	19/1

	TABLE E27

	Antibiotic (μg/ml)

Combined drug	MIC₅₀after combined use	MIC₉₀after combined use

EA + AMK	4	8
EA + SXT	19/1	19/1

The test results shows that, with the single use of the Pithecellobium clypearia Benth 60% ethanol extract to the ESBL-producing ECOs, the MIC₅₀is 800 μg/ml, the MIC₉₀is 800 μg/ml, the MBC₅₀is 1600 μg/ml, and the MBC₉₀is 1600 μg/ml.
For the 20 ESBL-producing ECOs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the AMK that the two drugs have no antagonistic effect, wherein 70% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to ¼ MIC, the MIC₅₀of the AMK is reduced from single-use 16 μg/ml to 4 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 64 μg/ml to 8 μg/ml.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 60% ethanol extract and the SXT to the 20 ESBL-producing ECOs that the two drugs have no antagonistic effect, wherein 30% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 60% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀and the MIC₉₀of the SXT are respectively reduced from single-use 2432/128 μg/ml to 19/1 μg/ml, and are reduced by 99.3%.
2.4. In-vitro inhibitory test results of the Pithecellobium clypearia Benth 95% ethanol extract and the two antibiotics (the AMK and the SXT) to the ESBL-producing ECOs are shown in table E28.
In-vitro bactericidal test results of the Pithecellobium clypearia Benth 95% ethanol extract to the ESBL-producing ECOs are shown in table E29.
The statistic analysis on in-vitro inhibitory and bactericidal MIC₅₀and MIC₉₀of the Pithecellobium clypearia Benth 95% ethanol extract and the two antibiotics to the ESBL-producing ECOs is shown in table E30.
The statistic analysis on bactericidal MBC₅₀and MBC₉₀of the Pithecellobium clypearia Benth 95% ethanol extract to the ESBL-producing ECOs is shown in table E31.
FIC values of a combined drug sensitive test of the Pithecellobium clypearia Benth 95% ethanol extract and the two antibiotics and distribution statistical results of the FIC values are shown in table E32 and table E33.
The sensibilization effects of the Pithecellobium clypearia Benth 95% ethanol extract to the two antibiotics and the MIC₅₀and MIC₉₀after combined use are shown in tables E34-E36.

	TABLE E28

	MIC (μg/ml)

	Strain No.	EA	AMK	SXT

	TABLE E29

	Strain No.	MBC(μg/ml)

	E1	3200
	E2	3200
	E3	3200
	E4	3200
	E5	3200
	E6	3200
	E7	3200
	E8	3200
	E9	3200
	E10	3200
	E11	3200
	E12	3200
	E13	3200
	E14	3200
	E15	3200
	E16	3200
	E17	3200
	E18	3200
	E19	3200
	E20	3200

	TABLE E30

	MIC (μg/ml)

	Drug	Range	MIC₅₀	MIC₉₀

EA	1600	1600	1600
AMK	4-512	16	64
SXT	76/4-2432/128	2432/128	2432/128

	TABLE E31

	MBC (μg/ml)

Drug	Range	MBC₅₀	MBC₉₀

EA	3200	3200	3200

	TABLE E32

	FIC

	Strain No.	EA + AMK	EA + SXT

E1	1	0.507813
E2	0.5	0.507813
E3	0.53125	0.507813
E4	0.5	0.75
E5	0.5	0.507813
E6	0.75	0.507813
E7	0.75	0.503906
E8	0.75	0.507813
E9	0.75	0.503906
E10	0.75	0.507813
E11	0.75	0.75
E12	0.5	1.000975
E13	0.75	0.507813
E14	0.75	0.507813
E15	0.75	0.500058
E16	0.5	0.132813
E17	0.75	0.507813
E18	0.5	1.000977
E19	0.375	0.625
E20	0.5	0.75

TABLE E33

FIC Range	EA + AMK	EA + SXT

FIC ≤ 0.5	40%	5%
0.5 < FIC ≤ 1	60%	85%
1 < FIC ≤ 2	—	10%
FIC > 2	—	—

TABLE E34

	EA	EA	AMK	AMK
Strain	single-use	combined-use	single-use	combined-use
No.	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)

E1	1600	800	4	2
E2	1600	400	16	4
E3	1600	800	512	16
E4	1600	400	4	1
E5	1600	400	16	4
E6	1600	800	4	1
E7	1600	800	32	8
E8	1600	800	32	8
E9	1600	800	64	16
E10	1600	400	8	4
E11	1600	800	32	8
E12	1600	400	32	8
E13	1600	400	4	2
E14	1600	800	8	2
E15	1600	400	8	4
E16	1600	400	16	4
E17	1600	800	8	2
E18	1600	400	128	32
E19	1600	400	64	8
E20	1600	400	16	4

TABLE E35

	EA	EA	SXT	SXT
Strain	single-use	combined-use	single-use	combined-use
No.	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)	MIC (μg/ml)

E1	1600	800	2432/128	19/1
E2	1600	800	2432/128	19/1
E3	1600	800	2432/128	19/1
E4	1600	800	76/4	19/1
E5	1600	800	2432/128	19/1
E6	1600	800	2432/128	19/1
E7	1600	800	2432/128	9.5/0.5
E8	1600	800	2432/128	19/1
E9	1600	800	2432/128	9.5/0.5
E10	1600	800	2432/128	19/1
E11	1600	800	76/4	19/1
E12	1600	1600	2432/128	2.375/0.125
E13	1600	800	2432/128	19/1
E14	1600	800	2432/128	19/1
E15	1600	800	2432/128	0.148438/0.078125
E16	1600	200	2432/128	19/1
E17	1600	800	2432/128	19/1
E18	1600	1600	2432/128	2.375/0.125
E19	1600	800	152/8	19/1
E20	1600	800	76/4	19/1

	TABLE E36

	Antibiotic (μg/ml)

The test results shows that, with the single use of the Pithecellobium clypearia Benth 95% ethanol extract to the ESBL-producing ECOs, the MIC₅₀is 1600 μg/ml, the MIC₉₀is 1600 μg/ml, the MBC₅₀is 3200 μg/ml, and the MBC₉₀is 3200 μg/ml.
For the 20 ESBL-producing ECOs, it is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the AMK that the two drugs have no antagonistic effect, wherein 50% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to ½ MIC, the MIC₅₀of the AMK is reduced from single-use 16 μg/ml to 4 μg/ml and is reduced by 75%; and the MIC₉₀is reduced from 64 μg/ml to 16 μg/ml and is reduced by 75%.
It is indicated by FIC≤2 with the combined use of the Pithecellobium clypearia Benth 95% ethanol extract and the SXT to the 20 ESBL-producing ECOs that the two drugs have no antagonistic effect, wherein 20% with FIC≤0.5 have the synergistic effect. When the Pithecellobium clypearia Benth 95% ethanol extract is smaller than or equal to the single-use MIC, the MIC₅₀and the MIC₉₀of the SXT are respectively reduced from single-use 2432/128 μg/ml to 19/1 μg/ml, and are reduced by 99.3%.
IV. Inhibitory and Bactericidal Tests of ESBL-Producing Klebsiella pneumoniae (Hereinafter Referred to as an ESBL-Producing KPN) Resistance of the EA

Embodiment 4

1. Test Method: The ESBL-Producing KPN (Serial No.: K1-K20) Strains are Tested and are Evaluated with Reference to the Inhibitory and Bactericidal Test Method in the First Embodiment.
2. Test Results
In-vitro inhibitory and bactericidal test results of the Pithecellobium clypearia Benth water extract to the ESBL-producing KPNs are shown in table K1.
The statistic analysis on in-vitro inhibitory and bactericidal MIC₅₀, MIC₉₀, MBC₅₀and MBC₉₀of the Pithecellobium clypearia Benth water extract to the ESBL-producing KPNs is shown in table K2 and table K3.
In-vitro inhibitory and bactericidal test results of the Pithecellobium clypearia Benth 10% ethanol extract to the ESBL-producing KPNs are shown in table K4.
The statistic analysis on in-vitro inhibitory and bactericidal MIC₅₀, MIC₉₀, MBC₅₀and MBC₉₀of the Pithecellobium clypearia Benth 10% ethanol extract to the ESBL-producing KPNs is shown in table K5 and table K6.
In-vitro inhibitory and bactericidal test results of the Pithecellobium clypearia Benth 60% ethanol extract to the ESBL-producing KPNs are shown in table K7.
The statistic analysis on in-vitro inhibitory and bactericidal MIC₅₀, MIC₉₀, MBC₅₀and MBC₉₀of the Pithecellobium clypearia Benth 60% ethanol extract to the ESBL-producing KPNs is shown in table K8 and table K9.
In-vitro inhibitory and bactericidal test results of the Pithecellobium clypearia Benth 95% ethanol extract to the ESBL-producing KPNs are shown in table K10.
The statistic analysis on in-vitro inhibitory and bactericidal MIC₅₀, MIC₉₀, MBC₅₀and MBC₉₀of the Pithecellobium clypearia Benth 95% ethanol extract to the ESBL-producing KPNs is shown in table K11 and table K12.

TABLE K1

In-vitro inhibitory and bactericidal test results of the Pithecellobium
clypearia Benth water extract to the ESBL-producing KPNs

Strain No.	MIC(μg/ml)	MBC(μg/ml)

K1	1600	>1600
K2	1600	>1600
K3	1600	>1600
K4	1600	>1600
K5	1600	>1600
K6	1600	>1600
K7	1600	>1600
K8	1600	>1600
K9	1600	>1600
K10	1600	>1600
K11	1600	>1600
K12	1600	>1600
K13	1600	>1600
K14	1600	>1600
K15	1600	>1600
K16	1600	>1600
K17	1600	>1600
K18	1600	>1600
K19	1600	>1600
K20	1600	>1600

TABLE K2

In-vitro inhibitory MIC₅₀and MIC₉₀of the Pithecellobium clypearia
Benth water extract to the ESBL-producing KPNs

MIC Range	MIC₅₀	MIC₉₀

1600	1600	1600

TABLE K3

In-vitro inhibitory MBC₅₀and MBC₉₀of the Pithecellobium clypearia
Benth water extract to the ESBL-producing KPNs

MBC Range	MBC₅₀	MBC₉₀

>1600	>1600	>1600

TABLE K4

In-vitro inhibitory and bactericidal test results of the Pithecellobium
clypearia Benth 10% ethanol extract to the ESBL-producing KPNs

	Strain No.	MIC(μg/ml)	MBC(μg/ml)

K1	1600	>1600
K2	800	>1600
K3	1600	>1600
K4	800	>1600
K5	1600	>1600
K6	1600	>1600
K7	1600	>1600
K8	1600	>1600
K9	1600	>1600
K10	1600	>1600
K11	1600	>1600
K12	1600	>1600
K13	1600	>1600
K14	1600	>1600
K15	800	>1600
K16	800	>1600
K17	1600	>1600
K18	1600	>1600
K19	1600	>1600
K20	1600	>1600

TABLE K5

In-vitro inhibitory MIC₅₀and MIC₉₀of the Pithecellobium clypearia
Benth 10% ethanol extract to the ESBL-producing KPNs

MIC Range	MIC₅₀	MIC₉₀

800-1600	1600	1600

TABLE K6

In-vitro inhibitory MBC₅₀and MBC₉₀of the Pithecellobium clypearia
Benth 10% ethanol extract to the ESBL-producing KPNs

MBC Range	MBC₅₀	MBC₉₀

>1600	>1600	>1600

TABLE K7

In-vitro inhibitory and bactericidal test results of the Pithecellobium
clypearia Benth 60% ethanol extract to the ESBL-producing KPNs

	Strain No.	MIC(μg/ml)	MBC(μg/ml)

K1	1600	>1600
K2	800	>1600
K3	800	>1600
K4	800	>1600
K5	1600	>1600
K6	1600	>1600
K7	400	>1600
K8	800	>1600
K9	1600	>1600
K10	1600	>1600
K11	1600	>1600
K12	1600	>1600
K13	800	>1600
K14	800	>1600
K15	400	>1600
K16	800	>1600
K17	1600	>1600
K18	1600	>1600
K19	800	>1600
K20	800	>1600

TABLE K8

In-vitro inhibitory MIC₅₀and MIC₉₀of the Pithecellobium clypearia
Benth 60% ethanol extract to the ESBL-producing KPNs

MIC Range	MIC₅₀	MIC₉₀

400-1600	800	1600

TABLE K9

In-vitro inhibitory MBC₅₀and MBC₉₀of the Pithecellobium clypearia
Benth 60% ethanol extract to the ESBL-producing KPNs

MBC Range	MBC₅₀	MBC₉₀

>1600	>1600	>1600

TABLE K10

In-vitro inhibitory and bactericidal test results of the Pithecellobium
clypearia Benth 95% ethanol extract to the ESBL-producing KPNs

	Strain No.	MIC(μg/ml)	MBC(μg/ml)

K1	1600	>1600
K2	1600	>1600
K3	1600	>1600
K4	1600	>1600
K5	1600	>1600
K6	1600	>1600
K7	1600	>1600
K8	1600	>1600
K9	1600	>1600
K10	1600	>1600
K11	1600	>1600
K12	1600	>1600
K13	800	>1600
K14	800	>1600
K15	1600	>1600
K16	1600	>1600
K17	1600	>1600
K18	1600	>1600
K19	1600	>1600
K20	1600	>1600

TABLE K11

In-vitro inhibitory MIC₅₀and MIC₉₀of the Pithecellobium clypearia
Benth 95% ethanol extract to the ESBL-producing KPNs

MIC Range	MIC₅₀	MIC₉₀

800-1600	1600	1600

TABLE K12

In-vitro inhibitory MBC₅₀and MBC₉₀of the Pithecellobium clypearia
Benth 95% ethanol extract to the ESBL-producing KPNs

MBC Range	MBC₅₀	MBC₉₀

>1600	>1600	>1600

With the single use of the Pithecellobium clypearia Benth water extract to the ESBL-producing KPNs, the MIC₅₀is 1600 μg/ml, the MIC₉₀is 1600 μg/ml, and both the MBC₅₀and the MBC₉₀are greater than 1600 μg/ml.
With the single use of the Pithecellobium clypearia Benth 10% ethanol extract to the KPNs, the MIC₅₀is 1600 μg/ml, the MIC₉₀is 1600 μg/ml, and both the MBC₅₀and the MBC₉₀are greater than 1600 μg/ml.
With the single use of the Pithecellobium clypearia Benth 60% ethanol extract to the ESBL-producing KPNs, the MIC₅₀is 1600 μg/ml, the MIC₉₀is 1600 μg/ml, and both the MBC₅₀and the MBC₉₀are greater than 1600 μg/ml.
With the single use of the Pithecellobium clypearia Benth 95% ethanol extract to the ESBL-producing KPNs, the MIC₅₀is 1600 μg/ml, the MIC₉₀is 1600 μg/ml, and both the MBC₅₀and the MBC₉₀are greater than 1600 μg/ml.

Claims

What is claimed is:

1. A method of treating a disease caused by an Extended-Spectrum Beta-Lactamase (ESBL) producing Escherichia coli (ECO) resistant infection, comprising administering an ESBL-producing ECO resistant drug comprising a Pithecellobium clypearia Benth Extract (EA) or an ESBL-producing ECO resistant antibiotic sensitizing drug comprising an EA.

2. The method of claim 1, wherein the EA is a Pithecellobium clypearia Benth water extract or a Pithecellobium clypearia Benth ethanol extract.

3. The method of claim 2, wherein the Pithecellobium clypearia Benth water extract or the Pithecellobium clypearia Benth ethanol extract is prepared with a following method: extracting Pithecellobium clypearia Benth coarse powder with water or an ethanol aqueous solution having a concentration of 10%-95% by a volume ratio, and then extracting an obtained extracting solution with ethyl acetate, in which the obtained extract is a final product.

4. The method of claim 3, wherein the ethanol aqueous solution is an ethanol aqueous solution having the concentration of 60% by the volume ratio.

5. The method of claim 1, wherein the antibiotic is an Amikacin (AMK) or a Compound Sulfamethoxazole (SXT).