Premna species, particularly Premna serratifolia (commonly known as "Agnimantha" in Ayurveda), have been traditionally used in various ethnomedicinal systems across Asia and Africa for their purported antimicrobial properties. In Ayurveda, Premna is a key ingredient in classical formulations such as Dashamoola, used for treating fever, inflammation, and infections. Folk medicine practitioners have used decoctions or extracts of Premna leaves, bark, and roots as remedies for wounds, respiratory infections, and gastrointestinal disturbances—conditions often associated with microbial activity. Scientific research has provided some preliminary support for these traditional uses. In vitro studies have shown that extracts of Premna serratifolia and related species possess antibacterial activity against certain gram-positive and gram-negative bacteria, including Staphylococcus aureus and Escherichia coli. However, these findings are limited to laboratory studies and lack robust clinical validation in humans. The active compounds responsible for the antimicrobial effects are thought to include flavonoids, phenolics, and essential oils. Overall, while there is traditional justification and some laboratory evidence for Premna’s use as an alternative or adjunct to antibiotics, there is insufficient clinical evidence to recommend it as a standalone treatment for infections. Its use is best understood within the context of traditional medicine, pending further research.