Antibiotic resistance is a global health concern; the rise of drug-resistant bacterial infections is compromising the medical advances that resulted from the introduction of antibiotics at the beginning of the 20th century. Considering that the presence of mutations within individuals in a bacterial population may allow a subsection to survive and propagate in response to selective pressure, as long as antibiotics are used in the treatment of bacterial infections, development of resistance is an inevitable evolutionary outcome. This, combined with the lack of novel antibiotics being released to the clinical market, means the need to develop alternative strategies to treat these resistant infections is critical. We discuss how the use of antibiotic adjuvants can minimise the appearance and impact of resistance. To this effect, several phenothiazine-derived drugs have been shown to potentiate the activities of antibiotics used to treat infections caused by Gram-positive and Gram-negative bacteria. Outside of their role as antipsychotic medications, we review the evidence to suggest that phenothiazines possess inherent antibacterial and efflux inhibitory properties enabling them to potentially combat drug resistance. We also discuss that understanding their mode of action is essential to facilitate the design of new phenothiazine derivatives or novel agents for use as antibiotic adjuvants.

中文翻译：

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吩噻嗪是否具有抗菌和外排抑制特性？

抗生素耐药性是全球性的健康问题。耐药细菌感染的兴起正在损害20世纪初由于引入抗生素而引起的医学进步。考虑到细菌种群中个体内部突变的存在，可能会使得该小节在选择性压力的作用下存活并繁殖，只要将抗生素用于治疗细菌感染，耐药性的发展是必然的进化结果。再加上缺乏向市场投放的新型抗生素，这意味着需要开发替代策略来治疗这些耐药性感染至关重要。我们讨论了使用抗生素佐剂如何最大程度地减少耐药性的出现和影响。为此，几种吩噻嗪衍生的药物已显示出增强用于治疗革兰氏阳性和革兰氏阴性细菌感染的抗生素活性的作用。除了它们作为抗精神病药物的作用之外，我们回顾了证据表明吩噻嗪具有固有的抗菌和外排抑制特性，从而使其有可能对抗耐药性。我们还讨论了了解它们的作用方式对于促进新型吩噻嗪衍生物或用作抗生素佐剂的新型药物的设计至关重要。我们审查了证据，表明吩噻嗪具有固有的抗菌和外排抑制特性，使它们有可能与耐药性作斗争。我们还讨论了了解它们的作用方式对于促进新的吩噻嗪衍生物或用作抗生素佐剂的新型药物的设计至关重要。我们审查了证据，表明吩噻嗪具有固有的抗菌和外排抑制特性，使它们有可能与耐药性作斗争。我们还讨论了了解它们的作用方式对于促进新的吩噻嗪衍生物或用作抗生素佐剂的新型药物的设计至关重要。