Piperine, a trans-trans isomer of 1-piperoyl-piperidine, in combination with ciprofloxacin markedly reduced the MICs and mutation prevention concentration of ciprofloxacin for Staphylococcus aureus , including methicillin-resistant S. aureus . The enhanced accumulation and decreased efflux of ethidium bromide in the wild-type and mutant (CIP r -1) strains in the presence of piperine suggest its involvement in the inhibition of bacterial efflux pumps.
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Khan et al. (2006) studied this question.
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