Effects of Glutathione on Antibiotic Susceptibility and Resistance in Bacteria: A Comprehensive Review

Antibiotic resistance has spread globally among bacterial pathogens, becoming a significant challenge to public health. Bacterial cells have an enormous capability to acquire various antibiotic resistance mechanisms. The effectiveness of many antibiotics relies on the intracellular redox balance and the bacteria's ability to mount stress responses. Glutathione (GSH) is an intracellular tripeptide antioxidant that significantly contributes to maintaining optimal redox balance, which may impact bacterial survival during antibiotic treatment. Neutralizing oxidative stress caused by antibiotics can reduce their effectiveness. However, alterations of the redox balance of GSH can impair normal cellular metabolism, making cells vulnerable. Altering the redox balance, either by depleting or increasing levels of GSH, can enhance the effectiveness of antibiotics. The influence of GSH on antibiotics varies depending on the bacterial species and the class of antibiotics used. Due to the vital role of GSH in antibiotic effectiveness, targeting bacterial GSH metabolism can be used as an adjunctive approach to overcome antibiotic resistance. This review summarizes the relationship between GSH and antibiotic susceptibility and resistance in bacteria.