Resveratrol enhancement staphylococcus aureus survival under levofloxacin and photodynamic treatments

•Reactive oxygen species-based antimicrobial treatment may be hindered by natural antioxidants.•Administration of antioxidants should be avoided or limited during photodynamic inactivation and antibiotic therapy.•Resveratrol co-administered with levofloxacin increases bacterial survival 20-fold compared with levofloxacin alone.•Bacterial eradication by photodynamic inactivation therapy fails in the presence of resveratrol. Reactive oxygen species (ROS) are an efficient tool to eradicate micro-organisms owing to the capacity of these species to damage almost all types of biomolecules and to kill cells. The increase in mechanisms of antimicrobial resistance has led to the exploration of new strategies to eliminate micro-organisms that involve the production of ROS such as superoxide anion (O2•–) and hydrogen peroxide (H2O2). ROS are produced during several antimicrobial treatments, including antibiotic and photodynamic therapies. Among the natural antioxidants, resveratrol (RSV) is efficient at preventing damage from ROS, and every day more people incorporate it as a dietary or cosmetic supplement. However, the consequences of the administration of RSV during antimicrobial treatment are unknown. To investigate possible antagonistic or synergistic effects of RSV during antibiotic therapy (levofloxacin) or photodynamic therapy (visible radiation and methylene blue), killing of planktonic Staphylococcus aureus bacteria was evaluated in the presence of RSV. The results showed that the antimicrobial capacity of these therapies is significantly diminished when levofloxacin or methylene blue are co-administered with RSV, indicating that consumption of RSV during antimicrobial treatment must be, at least, cautioned. Moreover, considering the ROS antimicrobial activity of antibacterial agents, the topical addition of RSV may also affect the control of pathogens of the human body. The results presented in this article highlight the importance of the evaluation of possible antagonistic effects when an antimicrobial agent with ROS-mediated action is co-administrated with RSV.