Sulfonamides · Pharmacology

What is the primary mechanism of resistance developed by bacteria against sulfonamides?

  1. Increased efflux via ATP-dependent pumps
  2. Enzymatic acetylation of the drug by bacterial acetyltransferases
  3. Overproduction of PABA or mutations in dihydropteroate synthase
  4. Alteration of the 30S ribosomal binding site
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Correct answer: Overproduction of PABA or mutations in dihydropteroate synthase

Resistance commonly occurs through chromosomal mutations that lead to an overproduction of PABA, which outcompetes the drug, or by acquiring plasmids encoding a dihydropteroate synthase with low affinity for sulfonamides.

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