Multiple antibiotic resistance and efflux

Curr Opin Microbiol. 1998 Oct;1(5):516-23. doi: 10.1016/s1369-5274(98)80083-0.


Multiple antibiotic resistance in bacteria was at first thought to be caused exclusively by the combination of several resistance genes, each coding for resistance to a single drug. More recently, it became clear that such phenotypes are often achieved by the activity of drug efflux pumps. Some of these efflux pumps exhibit an extremely wide specificity covering practically all antibiotics, chemotherapeutic agents, detergents, dyes, and other inhibitors, the exception perhaps being very hydrophilic compounds. Such efflux pumps work with exceptional efficiency in Gram-negative bacteria through their synergistic interaction with the outer membrane barrier. It is disturbing that the antibacterial agents of the most advanced type, which are unaffected by common resistance mechanisms, are precisely the compounds whose use appears to select for multidrug-resistant mutants that overproduce these efflux pumps of wide specificity.

Publication types

  • Review

MeSH terms

  • ATP-Binding Cassette Transporters / metabolism
  • Biological Transport, Active
  • Carrier Proteins / metabolism*
  • Drug Resistance, Microbial / physiology*
  • Drug Resistance, Multiple / physiology*
  • Gram-Negative Bacteria / physiology*
  • Gram-Positive Bacteria / physiology*


  • ATP-Binding Cassette Transporters
  • Carrier Proteins