Efflux modulation as an antimicrobial strategy: mechanisms and translational perspectives
Abstract Efflux pumps are widely viewed as antibiotic resistance determinants, yet their roles in stress adaptation, virulence, quorum sensing, and biofilm formation make them context-dependent therapeutic targets. This Perspective distinguishes four efflux intervention strategies: direct inhibition, bioenergetic or membrane-mediated suppression, regulatory modulation, and dual-effect approaches. We examine why promising in vitro findings rarely translate clinically and argue that efflux-targeting strategies require defined therapeutic objectives and integrated multidisciplinary approaches.
Authors
- Andréía Bagliotti Meneguin (ORCID: https://orcid.org/0000-0001-9284-2819)
- Zidane Qriouet (ORCID: https://orcid.org/0000-0001-8527-7655)
- Fernando Rogerio Pavan (ORCID: https://orcid.org/0000-0002-6969-3963)
- Waleska Stephanie da Cruz Nizer (ORCID: https://orcid.org/0000-0002-5134-719X)
- Cesar Augusto Roque‐Borda (ORCID: https://orcid.org/0000-0002-9262-0383)
- Chongbing Liao (ORCID: https://orcid.org/0000-0001-9400-6603)
- Heitor Leocádio de Souza Rodrigues (ORCID: https://orcid.org/0000-0002-7855-8640)
- Subham Kumar Vishwakarma (ORCID: https://orcid.org/0000-0002-6530-6647)
Institutions
- Shanghai Medical College of Fudan University (CN)
- Fudan University (CN)
- Catholic University of Santa María (PE)
- Centro Universitário de Araraquara (BR)
- Universidade Estadual Paulista (Unesp) (BR)
Publication Details
- Journal
- npj Drug Discovery.
- Published
- 2026-10-12
- DOI
- https://doi.org/10.1038/s44386-026-00083-0
- Primary Topic
- Antibiotic Resistance in Bacteria
- Type
- article
- Field-Weighted Citation Impact
- 0.00