Physiologic recovery of Mycobacterium tuberculosis from drug injury: A molecular study of post antibiotic effect in vitro and in vivo

Here, we evaluated the long-standing hypothesis that PAE reflects the time required for bacteria to recover from drug-induced physiologic damage by comparing Mtb after varying durations of treatment with the HRZE in vitro. Our results revealed that longer drug exposure was associated with greater injury and adaptation during treatment, as well as slower recovery after treatment, i.e., longer PAE.

Our observation that PAE in Mtb depends on the duration of drug exposure and correlates with the degree of bacterial injury support the hypothesis that nonlethal physiologic damage contributes to PAE. Molecular evaluation of bacterial physiology provides a new basis for probing recovery from drug exposure and understanding PAE.