Central Asian Medicinal Plants as Emerging Sources of Antimicrobial Natural Products Against Multidrug-Resistant Pathogens: A Narrative Review

Abstract

Antimicrobial resistance (AMR) has been described by the World Health Organization as one of the most pressing global public health threats of the current decade, with resistant infections projected to cause substantially increased mortality in the coming years if the current, markedly slowed pace of new antibiotic discovery is not reversed. Plant-derived natural products have re-emerged as a major focus of anti-infective drug discovery, both as stand-alone antimicrobial agents and as adjuvants capable of restoring susceptibility to existing antibiotics against resistant pathogens. Central Asia, and Uzbekistan in particular, harbours an exceptionally rich and comparatively underexplored medicinal flora that has historically supplied globally important antimicrobial raw materials, most notably liquorice (Glycyrrhiza glabra). This review synthesises recent (2020-2026) evidence on the antimicrobial activity of several Central Asian plant genera against clinically important multidrug-resistant (MDR) pathogens, including methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase-producing Enterobacteriaceae, and MDR Pseudomonas aeruginosa and Acinetobacter baumannii. We discuss documented activity and putative mechanisms for Glycyrrhiza glabra, whose isoflavonoid glabridin has recently been shown to disrupt MRSA biofilm formation and whose chromatographic fractions contain compounds active against multiple MDR Gram-negative and Gram-positive pathogens; for Ferula species, whose sesquiterpene coumarins possess documented antibacterial and antifungal activity; for Peganum harmala, whose β-carboline alkaloids exhibit broad-spectrum antimicrobial effects; and for Mentha asiatica, a Central-Asian-native mint species whose essential oil constituents have been specifically reviewed for antimicrobial potential in the context of rising antibiotic resistance. We conclude that Central Asian flora constitutes a genuine, still largely untapped reservoir for anti-infective natural product discovery, but that the evidence base remains overwhelmingly preclinical and in vitro, and that standardised susceptibility testing against well-characterised MDR clinical isolates, mechanistic studies, and eventual translational and combination-therapy studies with existing antibiotics represent priority directions for future research.