Piper betle leaves contain diverse phytochemicals including phenolics, alkaloids, and flavonoids that demonstrate significant inhibitory effects against both Gram-positive and Gram-negative bacteria, particularly Staphylococcus aureus and Escherichia coli. The review analyzes extraction methodologies, mechanistic aspects of antimicrobial action, and efficacy against specific pathogens. Applications across multiple domains are explored, including clinical treatments for ocular and dental infections, advanced wound healing systems, food preservation through biodegradable packaging, and functional materials development. Despite promising results, challenges remain in standardization, active compound identification, and delivery system optimization. By synthesizing research from the past five years, this review provides a foundation for future development of P. betle-based antimicrobial applications that may help address the global challenge of antimicrobial resistance.
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