Antagonistic Interaction Between Piper betle and Peperomia pellucida Ethanolic Extracts Reduces Antibacterial Activity Against Cutibacterium acnes
DOI:
https://doi.org/10.53905/igim.v1i03.17Keywords:
acne vulgaris, cutibacterium acnes, piper betle, peperomia pellucida, antibacterial activity, extract combinationAbstract
Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit in which Cutibacterium acnes plays a central pathogenic role. Rising resistance of C. acnes to conventional antibiotics such as clindamycin has intensified interest in plant-derived alternatives. This study aimed to evaluate the antibacterial activity of combined ethanolic extracts of green betel leaf (Piper betle) and pepper elder leaf (Peperomia pellucida) against C. acnes and to determine the combination ratio with the strongest antibacterial effect. A true experimental, post-test-only control group design was used. Leaves were macerated in 95% ethanol (1:10, w/v) for three days. Seven treatment groups were tested by the Kirby-Bauer disc diffusion method: single extract of P. betle 15%, single extract of P. pellucida 15%, combinations at ratios of 1:1, 1:2, and 2:1 at a fixed total concentration of 15%, a positive control (standardized clindamycin disc), and a negative control (sterile distilled water). Each group was replicated four times, determined using the Federer formula. Zones of inhibition were measured with a caliper after 24 h of incubation at 37 °C. Data were analyzed with Shapiro-Wilk, Levene's, one-way ANOVA, and Tukey's HSD post-hoc tests (α = 0.05). All extract treatments inhibited C. acnes growth. The single P. betle 15% extract produced the largest inhibition zone among plant treatments (12.19 ± 0.44 mm, strong category), whereas single P. pellucida 15% extract produced 8.96 ± 0.30 mm (moderate category). Combination ratios of 1:1, 1:2, and 2:1 produced inhibition zones of 9.57 ± 0.77 mm, 8.76 ± 0.39 mm, and 8.56 ± 0.73 mm, respectively, all within the moderate category. The positive control produced 27.19 ± 0.95 mm (very strong), while the negative control produced no inhibition zone. One-way ANOVA revealed a statistically significant difference among treatment groups (p < 0.001), and Tukey's HSD indicated that the combinations did not significantly exceed the single P. pellucida extract, while the single P. betle extract significantly outperformed all combination ratios. Combined ethanolic extracts of P. betle and P. pellucida exhibit antibacterial activity against C. acnes, but combination did not enhance efficacy beyond that of the single P. betle extract, suggesting an antagonistic rather than synergistic interaction. The 1:1 ratio was the most effective among the combinations tested.
References
Abdelmalek, S., Al-Banna, Y., Hajar, M., Mansoor, K., & Collier, P. (2025). Essential Oil-Mediated Potentiation of Erythromycin Against Resistant and Sensitive Cutibacterium acnes: Implications for Antimicrobial Resistance Management. Medical Research Archives, 13(11). https://doi.org/10.18103/mra.v13i11.7064
Abere, T. A., Agoreyo, F. O., & Eze, G. I. (2012). Phytochemical, Antimicrobial and ToxIicological evaluation of the leaves of Peperomia Pellucida (L.) HBK (Piperaceae). Journal of Pharmaceutical and Allied Sciences, 9(3), 1637–1652. https://www.ajol.info/index.php/jophas/article/view/84537
Aditya, R. (2023). Karakterisasi dan rendemen ekstrak etanol 96% daun sirih hijau (Piper betle L.) dengan metode maserasi. In Jurnal Farmasi Indonesia. Jurnal Farmasi Indonesia.
Angelini, P. (2024). Plant-Derived Antimicrobials and Their Crucial Role in Combating Antimicrobial Resistance. Antibiotics, 13(8), 746–746. https://doi.org/10.3390/antibiotics13080746
Asan, N. U. A., Rukayadi, Y., & Tan, G. H. (2022). Antibacterial activity of Sireh (Piper betle L.) leaf extracts for controlling bacterial leaf blight diseases in rice plant. Malaysian Journal of Microbiology. https://doi.org/10.21161/mjm.221395
Boripun, R., Paopradit, P., Prampramote, J., Narinthorn, R., Intongead, S., Sangkanu, S., Narongrit, T., & Mitsuwan, W. (2022). Bactericidal activity of Piper betle L. extract against antibiotic resistant Salmonella spp. isolated from pig farms in Southern Thailand. Veterinary Integrative Sciences, 20(3), 557–569. https://doi.org/10.12982/vis.2022.042
Caesar, L. K., & Cech, N. B. (2019). Synergy and antagonism in natural product extracts: when 1 + 1 does not equal 2. Natural Product Reports, 36(6), 869–888. https://doi.org/10.1039/c9np00011a
Caesar, L. K., Kellogg, J. J., Kvalheim, O. M., & Cech, N. B. (2019). Opportunities and Limitations for Untargeted Mass Spectrometry Metabolomics to Identify Biologically Active Constituents in Complex Natural Product Mixtures. Journal of Natural Products, 82(3), 469–484. https://doi.org/10.1021/acs.jnatprod.9b00176
Cui, H., Guo, C., Wang, Q., Feng, C., & Duan, Z. (2022). A pilot study on the efficacy of topical lotion containing anti-acne postbiotic in subjects with mild -to -moderate acne. Frontiers in Medicine, 9, 1064460–1064460. https://doi.org/10.3389/fmed.2022.1064460
Guo, Y., Yang, X., Tang, L., Tao, L., Xiao, R., & Liu, Q. (2025). Validation of Madecassoside Synergy Significantly Enhanced Cryptotanshinone’s Therapeutic Efficacy Against Acne Vulgaris. Bioengineering, 12(9), 935–935. https://doi.org/10.3390/bioengineering12090935
Hay, R. A., Shalaby, K., Zaher, H., Hafez, V., Chi, C., Dimitri, S., Nabhan, A., & Layton, A. (2016). Interventions for acne scars. Cochrane Database of Systematic Reviews, 2016(4). https://doi.org/10.1002/14651858.cd011946.pub2
Herdiana, I., Haerussana, A. N. E. M., Syahla, N., Melawati, N., & Diniyati, S. N. (2023). Potensi Aktivitas Antibakteri Kombinasi Ekstrak Daun Sirih Hijau, Sirih Merah Dan Sirih Hitam Terhadap Bakteri Propionibacterium acne. Jurnal Bahana Kesehatan Masyarakat (Bahana of Journal Public Health), 7(2), 52–57. https://doi.org/10.35910/jbkm.v7i2.680
Huang, L., Yang, S., Yu, X., Fang, F., Zhu, L., Wang, L., Zhang, X., Changzhi, Y., Qian, Q., & Zhu, T. (2024). Association of different cell types and inflammation in early acne vulgaris. Frontiers in Immunology, 15, 1275269–1275269. https://doi.org/10.3389/fimmu.2024.1275269
Junio, H. A., Sy‐Cordero, A. A., Ettefagh, K. A., Burns, J. T., Micko, K. T., Graf, T. N., Richter, S. J., Cannon, R. E., Oberlies, N. H., & Cech, N. B. (2011). Synergy-Directed Fractionation of Botanical Medicines: A Case Study with Goldenseal (Hydrastis canadensis). Journal of Natural Products, 74(7), 1621–1629. https://doi.org/10.1021/np200336g
Karadağ, A. S., Kayıran, M. A., Wu, C., Chen, W., & Parish, L. C. (2020). Antibiotic resistance in acne: changes, consequences and concerns. Journal of the European Academy of Dermatology and Venereology, 35(1), 73–78. https://doi.org/10.1111/jdv.16686
Legiawati, L., Halim, P. A., Fitriani, M., Hikmahrachim, H. G., & Lim, H. W. (2023). Microbiomes in Acne Vulgaris and Their Susceptibility to Antibiotics in Indonesia: A Systematic Review and Meta-Analysis. Antibiotics, 12(1), 145–145. https://doi.org/10.3390/antibiotics12010145
Marchese, A., Barbieri, R., Coppo, E., Orhan, İ. E., Daglia, M., Nabavi, S. F., Nabavi, S. M., Izadi, M., Abdollahı, M., Nabavi, S. M., Nabavi, S. M., & Ajami, M. (2017). Antimicrobial activity of eugenol and essential oils containing eugenol: A mechanistic viewpoint. Critical Reviews in Microbiology, 43(6), 668–689. https://doi.org/10.1080/1040841x.2017.1295225
Nelson, K., Lyles, J. T., Li, T., Saitta, A., Addie-Noye, E., Tyler, P., & Quave, C. L. (2016). Anti-Acne Activity of Italian Medicinal Plants Used for Skin Infection. Frontiers in Pharmacology, 7, 425–425. https://doi.org/10.3389/fphar.2016.00425
Pirrone, V., Thakkar, N., Jacobson, J. M., Wigdahl, B., & Krebs, F. C. (2011). Combinatorial Approaches to the Prevention and Treatment of HIV-1 Infection. Antimicrobial Agents and Chemotherapy, 55(5), 1831–1842. https://doi.org/10.1128/aac.00976-10
Putrajaya, F., Hasanah, N., & Kurlya, A. (2019). Daya Hambat Ekstrak Etanol Daun Suruhan (Peperomia pellucida l.) Terhadap Pertumbuhan Bakteri Penyebab Jerawat (Propionibacterium acnes) Dengan Metode Sumur Agar. Edu Masda Journal, 3(2), 123–123. https://doi.org/10.52118/edumasda.v3i2.34
Rasoanaivo, P., Wright, C. W., Willcox, M., & Gilbert, B. (2011). Whole plant extracts versus single compounds for the treatment of malaria: synergy and positive interactions. Malaria Journal, 10. https://doi.org/10.1186/1475-2875-10-s1-s4
Subramani, R., Mathivanan, N., & Feussner, K.-D. (2017). Plant-derived antimicrobials to fight against multi-drug-resistant human pathogens. 3 Biotech, 7(3), 172–172. https://doi.org/10.1007/s13205-017-0848-9
Wahyuni, S. T., Rahmasari, D., Nugroho, R. S., Agusta, I., Daminda, R. D. K., Sundugesti, R. V., & Ermawati, D. E. (2023). Enhanced Antibacterial Activity of Piper betle Extract Niosome Serum Gel and Its Irritation Effects. KnE Medicine. https://doi.org/10.18502/kme.v3i2.13050
Zahrah, H., Mustika, A., & Debora, K. (2019). Aktivitas Antibakteri dan Perubahan Morfologi dari Propionibacterium Acnes Setelah Pemberian Ekstrak Curcuma Xanthorrhiza. Jurnal Biosains Pascasarjana, 20(3), 160–160. https://doi.org/10.20473/jbp.v20i3.2018.160-169
Zhang, B., Choi, Y. M., Lee, J., An, I. S., Li, L., He, C., Dong, Y., Bae, S., & Meng, H. (2019). Toll-like receptor 2 plays a critical role in pathogenesis of acne vulgaris. Biomedical Dermatology, 3(1). https://doi.org/10.1186/s41702-019-0042-2
Zhang, Y., Jiang, Y., Zhao, J., Mo, Q., Wang, C., Wang, D., & Li, M. (2023). Weizmannia coagulans Extracellular Proteins Reduce Skin Acne by Inhibiting Pathogenic Bacteria and Regulating TLR2/TRAF6-Mediated NF-κB and MAPKs Signaling Pathways. Probiotics and Antimicrobial Proteins, 17(2), 705–720. https://doi.org/10.1007/s12602-023-10175-2
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2026 Heny Buwe Leo, Tadeus Andreas Lada Regaletha, Cahyani Purnasari, Nurul Fatmawati Pua Upa (Author)

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).
You are free to:
-
Share — copy and redistribute the material in any medium or format
-
Adapt — remix, transform, and build upon the material for any purpose, even commercially
Under the following terms:
-
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
-
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
For more information, please visit:
https://creativecommons.org/licenses/by-sa/4.0/


