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

Marta Martins, Sujata G. Dastidar, Seamus Fanning, Jette E. Kristiansen, Joseph Molnar, Jean-Marie Pages, Zsuzsanna Schelz, Gabriella Spengler, Miguel Viveiros, Leonard Amaral

Research output: Contribution to journalReview article


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. 

Original languageEnglish
Pages (from-to)198-208
Number of pages11
JournalInternational Journal Of Antimicrobial Agents
VolumeVol. 31
Issue numbern.º 3
Publication statusPublished - Mar 2008


  • Multidrug resistance
  • Gram-negative bacteria
  • Efflux pumps
  • Efflux pump inhibitors
  • Non-antibiotics
  • Helper compounds
  • Staphylococcus-aureus mrsa
  • CA2+-activated K+ Channel
  • Escherichia-coli
  • Mycobacterium-tuberculosis
  • In-Vitro
  • Campylobacter-jejuni
  • Antimicrobial resistance
  • Antitubercular activity
  • Outer-membrane

UN Sustainable Development Goals (SDGs)

  • SDG 3 - Good Health and Well-Being

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