Herbal Medicines Used for Tuberculosis Worldwide: A Systematic Review of Ethnobotanical, Preclinical, and Clinical Evidence

Astani, Akram; Akhondi Meybodi, Zohreh; Heidari, Faezehsadat; Dehghani, Maryam; Akhundi Meybodi, Hedayat; Nabimeybodi, Razieh

Herbal Medicines Used for Tuberculosis Worldwide: A Systematic Review of Ethnobotanical, Preclinical, and Clinical Evidence

Articles in Press

Document Type : Review Article

Authors

Akram Astani

Zohreh Akhondi Meybodi

Faezehsadat Heidari

Maryam Dehghani

Hedayat Akhundi meybodi

Razieh Nabimeybodi

Abstract

Introduction: Tuberculosis (TB) presents an increasing global health threat, driven by mounting drug resistance. This has intensified the search for affordable treatment options, such as herbal medicines, whose safety and effectiveness are assessed in this systematic review.
Materials and Methods: To address this objective, this PRISMA-compliant systematic review evaluates herbal medicines for TB treatment globally. We searched Web of Science, Cochrane Library, Scopus, ScienceDirect, PubMed, and Google Scholar (1980–August 2025) using MeSH and free-text terms (e.g., “Tuberculosis AND Herbal Medicines”).
Results: From 1,176 articles, 40 studies (in vitro, field, and clinical) were included, identifying 245 plant species (e.g., Acalypha indica, Capparis spinosa) with anti-TB activity (IC50 < 0.5 mg/mL). India, South Africa, and Uganda reported the most species. In vitro studies dominate (37/40), with only 2–3 clinical trials, limiting practical use. Safety data are sparse, though Morella salicifolia showed no toxicity.
Conclusion: Herbal medicines represent promising candidates for future anti-tuberculosis drug discovery; however, their clinical utility in multidrug-resistant tuberculosis (MDR-TB) remains insufficiently validated. Future studies should focus on standardization of extracts, in vivo evaluation, toxicity assessment, and well-designed clinical trials to support evidence-based TB control strategies

Keywords

Ethnomedicinal plants

Mycobacterium tuberculosis

Systematic review

Anti-TB Activity