Comparative efficacy of andrographolide and hordenine in the treatment of methicillin resistant Staphylococcus aureus infected wounds: a multifaceted approach

BACKGROUND: Wound healing is a multifaceted biological process hindered by infections, especially the methicillin-resistant Staphylococcus aureus (MRSA), which resists antibiotics. Natural compounds such as andrographolide and hordenine are being explored as alternative therapeutics. OBJECTIVE: To compare the efficacy of andrographolide and hordenine in promoting wound healing in MRSA-infected infectious wounds using in vitro and in vivo methods. METHODS: L929 fibroblast-based MTT and scratch assays assessed cytotoxicity and wound closure potential. CAM assay evaluated angiogenic activity. Wistar rats with MRSA-infected excision wounds were treated topically, followed by biochemical analysis (hydroxyproline and hexosamine levels) and histopathological evaluation. RESULTS: The study revealed that andrographolide showed significantly (P < 0.001) higher cellular viability than hordenine and significantly reduced the cellular gap in L929 cells by day 3. Andrographolide increased blood vessels significantly (P < 0.001) more than hordenine. Clinical observations indicated reduced pus in andrographolide and hordenine-treated groups than in the control group, with the ceftriaxone-sulbactam group showing the lowest pus formation. Hexosamine levels were comparable in both treatments, while hydroxyproline was higher in the hordenine group. Histopathology showed hordenine-treated animals had faster wound healing and enhanced epithelialisation compared to andrographolide-treated animals. CONCLUSION: Andrographolide and hordenine exhibited wound healing activity in MRSA-infected wounds, promotes fibroblast proliferation and migration, as well as fostering angiogenesis.