Antibiotic efficacy is linked to bacterial cellular respiration

The global burden of antibiotic resistance has created a demand to better understand the basic mechanisms of existing antibiotics. Of significant interest is how antibiotics may perturb bacterial metabolism, and how bacterial metabolism may influence antibiotic activity. Here, we study the interaction of bacteriostatic and bactericidal antibiotics, the two major phenotypic drug classes. Interestingly, the two classes differentially perturb bacterial cellular respiration, with major consequences for their intrinsic activity both alone and in combination. Of note, bacteriostatic antibiotics decelerate cellular respiration, generating a metabolic state that is prohibitive to killing. Further, we show that the efficacy of bactericidal drugs can be improved by increasing basal respiration, and we identify a respiration-related drug target that potentiates the activity of bactericidal antibiotics.