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. 2020 Jun 3;11:1048. doi: 10.3389/fimmu.2020.01048

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Copyright © 2020 Rosini, Nicchi, Pizza and Rappuoli.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Schematic representation of the main mechanisms exploited by bacteria to tackle the action of antibiotics. (A) The inactivation of the drug by its hydrolysis or structural modification. (B) The prevention of the access to the target by reducing membrane permeability or overexpression of efflux pumps. (C) Changes in the antibiotic targets by mutation or post-translational modifications. (D) Resistance mechanism of Mycobacterium tuberculosis to isoniazid drug mutations in the katG gene causes the accumulation of the inactive form of the antibiotic inside the bacilli without the formation of active adduct.