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2 - BACTERIOWEB

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Therapeutic implications of efflux systems<br />

Resistance levels conferred by intrinsic pumps<br />

– Low to moderate drug resistance (MIC x 2 - 16)<br />

– Clinical significance<br />

♦ Lack of clinical data !<br />

♦ Poor response to treatment when the concentrations of<br />

antibiotics are low at the infection site (insufficient dosage,<br />

inappropriate drug, abcess...)<br />

♦ Increased emergence of target mutants ?<br />

Emergence of efflux mutants under treatment<br />

– Cross resistance to structurally unrelated molecules<br />

– Role of fluoroquinolones<br />

39

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