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The production of bacterial biofilms plays a critical role in the pathogenesis of serious invasive infection, including endocarditis, osteomyelitis, and biomedical-device infections. Prior research has shown that bacterial biofilm formation can be enhanced by subinhibitory concentrations of antibiotics. Now, investigators have examined the effect of subinhibitory concentrations of various antibiotics on biofilm formation in vitro on Enterococcus faecalis.
They observed that antibiotics that exert activity on the cell wall (fosfomycin, ampicillin, oxacillin, ceftriaxone) markedly increase biofilm formation at concentrations well below the minimum inhibitory concentrations, whereas antibiotics that act on protein, DNA, RNA, or folate synthesis…