Importance of efflux pumps in subjugating antibiotic resistance

Antibiotic resistance is defined as a condition that assists any disease-causing organism to resist antibiotics of different class with distinct structure and function directed for its elimination, thereby enabling the survival of the microorganism. Multiple resistance determinants play a major mechanism of bacterial resistance including multidrug efflux pumps. Different types of efflux pump mechanisms, such as single drug or multidrug-specific, are the significant determinants of resistance, either intrinsic or acquired, to the respective antibiotics. This has resulted in the development of efflux pump inhibitors (EPIs). By understanding the working mechanism of the efflux pump, various antibacterial agents known as efflux reversals can be described as EPIs, membrane permeabilizers, blockers, energy poisons, etc. Over the last few years a lot of effort was exerted to identify the new and unique EPIs; however, none was found suitable.