A standardized nomenclature for resistance-modifying agents in the Comprehensive Antibiotic Resistance Database

ABSTRACT Resistance-modifying agents have been historically underrepresented in the Comprehensive Antibiotic Resistance Database (CARD). In the process of curating over 60 new molecules into CARD’s Antibiotic Resistance Ontology, the limitations of current classification and nomenclature for these molecules were addressed. We propose a new standardized nomenclature based on mechanism of action, including inhibitors of antibiotic resistance mechanisms, adjuvants enhancing antibiotic entry, adjuvants inhibiting antibiotic removal, adjuvants that alter cell physiology, and host-related antibiotic adjuvants. IMPORTANCE While increasing rates of antimicrobial resistance undermine our current arsenal of antibiotics, resistance-modifying agents (RMAs) hold promise to extend the lifetime of these important molecules. We here provide a standardized nomenclature for RMAs within the Comprehensive Antibiotic Resistance Database in aid of RMA discovery, data curation, and genome mining.