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Understanding tolerance to cell wall-active antibiotics.

Tobias Dörr1

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Summary

Antibiotic tolerance, where bacteria survive bactericidal antibiotics, is a key factor in treatment failure. This review explores tolerance to cell wall-active (CWA) antibiotics, their mechanisms, and clinical impact.

Keywords:
antibiotic toleranceautolysinsbeta lactamspeptidoglycanphenotypic tolerance

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Area of Science:

  • Microbiology
  • Pharmacology
  • Infectious Diseases

Background:

  • Antibiotic tolerance is a significant, yet understudied, cause of antibiotic treatment failure.
  • Cell wall-active (CWA) antibiotics are crucial in clinical practice for treating bacterial infections.

Purpose of the Study:

  • To review the manifestations, mechanisms, and clinical relevance of bacterial tolerance to CWA antibiotics.
  • To discuss definitions, detection assays, and mechanisms of action for CWA antibiotics and bacterial tolerance.

Main Methods:

  • Literature review of scientific publications on antibiotic tolerance and CWA antibiotics.
  • Analysis of existing data on bacterial responses to CWA antibiotics and tolerance mechanisms.

Main Results:

  • Tolerance allows bacteria to survive bactericidal CWA antibiotics by mitigating cell damage.
  • Various mechanisms enable bacteria to develop tolerance to CWA antibiotics, impacting treatment efficacy.

Conclusions:

  • Antibiotic tolerance to CWA antibiotics is a clinically relevant phenomenon contributing to treatment failure.
  • Understanding tolerance mechanisms is vital for developing strategies to overcome antibiotic resistance and improve patient outcomes.