Can efflux inhibitors really counter resistance?

Efflux, particularly that mediated by the resistance-nodulation-division (RND) family of multiple antibiotic efflux systems that are prevalent in Gram-negative pathogenic bacteria, is of increasing concern as a mechanism of resistance to clinically important antimicrobials. In considering the continued utility of existing agents and the development of new ones, then, efflux must be taken into account. We describe here a number of approaches, realized and hypothetical, for avoiding or inhibiting efflux as a way of countering efflux-mediated resistance.

Section editors:Gary Woodnutt – CovX, San Diego, USAPaul-Henri Lambert – Centre of Vaccinology, University of Geneva, Switzerland