The bacterial outer membrane as a drug barrier.

The outer membranes of Gram-negative bacteria constitute a semi-permeable barrier, as indicated by the corresponding alterations in outer membrane permeability and in antibiotic susceptibility resulting from mutation or polycation action. Restricted outer membrane permeability works in synergy with co-determinant resistance mechanisms, such as the periplasmic enzyme beta-lactamase or active efflux mechanisms, bringing about antibiotic resistance.