Silver Enhances Antibiotic Activity Against Gram-Negative Bacteria

A declining pipeline of clinically useful antibiotics has made it imperative to develop more effective antimicrobial therapies, particularly against difficult-to-treat Gram-negative pathogens. Silver has been used as an antimicrobial since antiquity, yet its mechanism of action remains unclear. We show that silver disrupts multiple bacterial cellular processes, including disulfide bond formation, metabolism, and iron homeostasis. In this study the authors investigate how silver affects various aspects of bacterial physiology and enhances the efficacy of different antibiotics against Gram-negative bacteria. They also test the effects of silver and antibiotic combinations in vitro and in vivo, and find that they can eliminate bacterial persisters and biofilms, as well as sensitize Gram-negative bacteria to vancomycin, a Gram-positive–specific antibiotic.

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