Abstract

*Dr. Samriti, Dr. Pooja Sharma, Deeksha Kumari, Dr. Rijin Mohan, Dr. Shijo Y. J.

ABSTRACT

Background: Bhagandara (Fistula-in-ano) is a notoriously recurrent anorectal condition that Acharya Sushruta classified among the Ashta Mahagada due to its challenging management. Although Ksharasutra therapy remains a benchmark Ayurvedic intervention, limited scientific literature directly correlates its clinical success with microbiological assessments and Antimicrobial Sensitivity Testing (AST). Aim: This study evaluated the in vitro antimicrobial potency of two distinct Ksharasutra formulations against a pathogen isolated from an active Bhagandara tract. Materials and Methods: Purulent discharge was collected from a clinical fistulous tract and cultured on Nutrient and MacConkey Agar. The isolated pathogen was identified through Gram staining and standard biochemical tests (Indole, Catalase, Citrate). Two extracts - Extract A (Guggulu-based) and Extract B (Snuhi-based) - were tested at 100 mg/mL using the Agar Disc Diffusion method. Inhibition zones were compared against standard antibiotics (Amoxicillin-clavulanate, Meropenem) following CLSI guidelines. Results: The isolated pathogen was confirmed as Klebsiella oxytoca, a Gram-negative, lactose-fermenting bacillus. In the antimicrobial assay, Extract B (Snuhi-based) demonstrated superior activity with a 13 mm Zone of Inhibition (ZOI): outperforming Extract A (Guggulu-based, 9 mm ZOI) and notably exceeding the positive control, Amoxicillin-clavulanate (12 mm ZOI). Conclusion: These findings offer compelling, measurable evidence that Ksharasutra functions as more than a physical seton, it acts as an active, potent antimicrobial. The marked efficacy of the Snuhi-based formulation against Klebsiella oxytoca supports its traditional role in maintaining a Shuddha Vrana, driving simultaneous microbial clearance and tissue healing in complex anorectal fistulae.