How antibiotics work together: molecular mechanisms behind combination therapy

Geraldine J. Sullivan, Natasha N. Delgado, Ram Maharjan, Amy K. Cain*

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    24 Citations (Scopus)
    8 Downloads (Pure)


    Antibiotics used in combination are an effective strategy for combatting numerous infectious diseases in clinical and veterinary settings, particularly as a last-line therapy for difficult-to-treat cases. Combination therapy can either increase or slow the rate of killing, broaden the antibiotic spectrum, reduce dosage and unwanted side-effects, and even control the emergence of resistance. The administration of antibiotics in combination has been used effectively against bacterial infections for >70 years, first used to treat tuberculosis. However, effective antibiotic combinations and their dosage regimes have been largely determined empirically in the clinic, and the molecular mechanisms underpinning how these combinations work remains surprisingly elusive. This review focuses on studies that have outlined the genetics and molecular mechanisms of action underlying antibiotic combinations, as well as those that examine how resistance develops. We highlight the need for further experimentation and genetic validation to fully realise the potential of combination therapy.

    Original languageEnglish
    Pages (from-to)31-40
    Number of pages10
    JournalCurrent Opinion in Microbiology
    Early online date30 Jun 2020
    Publication statusPublished - Oct 2020

    Bibliographical note

    Copyright © 2020 Elsevier Ltd. All rights reserved. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


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