<![CDATA[Medicinal plant preparations have been extensively explored as sources of antimicrobial compounds. Nevertheless, antimicrobial activity should not be interpreted as direct evidence of biomedical applicability, because some bioactive extracts can disrupt erythrocyte membranes or produce blood-cell toxicity. Purpose: This systematic review integrates published evidence on medicinal plant extracts that were assessed for antimicrobial effects together with hemolytic or hemocompatibility-related safety. Methods: Literature searches were carried out in PubMed, Scopus, SpringerLink, Wiley Online Library, and MDPI using keyword combinations related to medicinal plants, antimicrobial activity, hemolysis, erythrocytes, and hemocompatibility. Articles published during 2014-2026 were selected using predetermined eligibility criteria. Results: The search retrieved 1,525 records. Following removal of 572 duplicates, 953 records were screened; 653 were excluded during title and abstract assessment, and 300 full-text reports were reviewed. Thirty studies fulfilled the inclusion criteria. The included articles mainly used in vitro antimicrobial approaches, such as inhibition-zone testing, MIC, MBC, antibiofilm, or antifungal assays, and paired them with hemolysis, erythrocyte membrane-stability, PBMC cytotoxicity, or related blood-cell safety assays. Conclusion: Medicinal plant extracts are best evaluated using an efficacy-safety perspective. Preparations that inhibit microbes at concentrations below hemolytic or cytotoxic thresholds represent stronger candidates for subsequent biomedical development.]]>
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