Potential role of non-antibiotics (helper compounds) in the treatment of multidrug-resistant Gram-negative infections: mechanisms for their direct and indirect activities

Int J Antimicrob Agents. 2008 Mar;31(3):198-208. doi: 10.1016/j.ijantimicag.2007.10.025. Epub 2008 Jan 3.

Abstract

Multidrug resistance in Gram-negative bacteria is now known to be primarily caused by overexpression of efflux pumps that extrude unrelated antibiotics from the periplasm or cytoplasm of the bacterium prior to their reaching their intended target. This review focuses on a variety of agents that have been shown to be efflux pump inhibitors (EPIs) and which, if used as 'helper compounds' in combination with antibiotics to which the organism is initially resistant, may produce the required cure. Although not all of the EPIs may serve a helper role owing to their toxicity, they may nevertheless serve as lead compounds.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Bacterial Agents / toxicity
  • Drug Resistance, Multiple, Bacterial / drug effects*
  • Enzyme Inhibitors / pharmacology*
  • Enzyme Inhibitors / toxicity
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / microbiology*
  • Humans

Substances

  • Anti-Bacterial Agents
  • Enzyme Inhibitors