Thank you. The question here is about CLINICAL TRIALS, since efflux pump inhibitors are not yet in use for therapeutic purpose as antibiotic adjuvants.
Sorry I don't know specifically about gram negative bacteria
We tried a similar approach in fungi showing efflux mediated MDR against agro fungicides. We found a few things that worked but the most efficient ones were already listed as drugs. With other words they have major farmacological effects. I think that is one of the limiting factors for therapeutic use, they are targetting something that has a homologeous protein in the host.
https://www.researchgate.net/publication/10854579_Modulators_of_membrane_drug_transporters_potentiate_the_activity_of_the_DMI_fungicide_oxpoconazole_against_Botrytis_cinerea?ev=prf_pub
There is also a nice publication hinting that there may be natural compounds that can work as MDR inhibitors
Reimann, S. and Deising, H.B. (2005) Inhibition of efflux transporter-mediated fungicide resistance in Pyrenophora tritici-repentis by a derivative of 4 '-hydroxyflavone and enhancement of fungicide activity. Appl. Environ. Microbiol., 71, 3269-3275.
Article Modulators of membrane drug transporters potentiate the acti...
Dear Dr. Schoonbeek thank you for the input.
You are right, many a times it could be the problem of homologous protein nature in the host, making it difficult for the therapeutic use.
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