Inhibition of the emergence of ciprofloxacin resistance in Streptococcus pneumoniae by the multidrug efflux inhibitor reserpine

Recent evidence supports the contribution of a multidrug efflux mechanism t o fluoroquinolone resistance in Streptococcus pneumoniae. In this paper I s how that reserpine, an inhibitor of multidrug transporters in grampositive bacteria, dramatically suppresses the in vitro emergence of ciprofloxacin-r esistant variants of S. pneumoniae, suggesting that the combination of a fl uoroquinolone with an inhibitor of multidrug transport may help preserve th e efficacy of this class of antibiotics.