Antibiotics and resistance: the two-sided coin of the mycobacterial cell wall

Sarah M Batt, Christopher E Burke, Alice R Moorey, Gurdyal S Besra

Research output: Contribution to journalReview articlepeer-review

2 Citations (Scopus)
204 Downloads (Pure)


Mycobacterium tuberculosis, the bacterium responsible for tuberculosis, is the global leading cause of mortality from an infectious agent. Part of this success relies on the unique cell wall, which consists of a thick waxy coat with tightly packed layers of complexed sugars, lipids and peptides. This coat provides a protective hydrophobic barrier to antibiotics and the host's defences, while enabling the bacterium to spread efficiently through sputum to infect and survive within the macrophages of new hosts. However, part of this success comes at a cost, with many of the current first- and second-line drugs targeting the enzymes involved in cell wall biosynthesis. The flip side of this coin is that resistance to these drugs develops either in the target enzymes or the activation pathways of the drugs, paving the way for new resistant clinical strains. This review provides a synopsis of the structure and synthesis of the cell wall and the major current drugs and targets, along with any mechanisms of resistance.

Original languageEnglish
Article number100044
JournalThe Cell Surface
Early online date2 Sept 2020
Publication statusPublished - Dec 2020

Bibliographical note

© 2020 The Author(s).


  • Arabinogalactan
  • Cell wall
  • Lipoarabinomannan
  • Mycobacterium tuberculosis
  • Mycolic acids

ASJC Scopus subject areas

  • Cell Biology
  • Molecular Biology
  • Applied Microbiology and Biotechnology
  • Microbiology


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