Surgical from different quarters across the globe[9 ].The emerging

 Surgical Site Infections(SSIs) are defined as
those infections occurring within 30 days of surgery (up to one year for
implants) affecting either the site of incision 
or deep tissues .2 SSIs are mainly caused by Staphylococcus aureus, Enterobacteria
species and E. coli. SSIs are found
in approximately 20% of patients who undergo surgical procedures .3 Existence of efflux pump (EP)
is  one 
of the major mechanisms  of  antibiotic resistance shown by bacteria4 In
a situation, where this is the sole mechanism of  resistance shown by an isolate,  for a particular drug , the possibility of use
of  EP inhibitor might be rewarding. Evaluation
of  the extent to which EP  is responsible for fluoroquinolone(FQ)
resistance would generate the required data as background information for
contemplating combined use EP inhibitor  and
FQs, at least topically in Surgical Site Infections, in view  of 
dwindling  options of
antimicrobial therapy due to emerging wide spread resistance.5


E. coli  is one of the major bacteria  for Surgical Site Infections 3 .Multi drug
resistance , including to FQs, in E. coli
are being reported from different quarters across the globe9 .The emerging
phenomenon has pushed the surgeons to depend on fourth generation
cephalosporins8, which  might be
rendered ineffective before long  by
spread of ‘New Delhi Beta Lactamase’ gene in hospitals10.

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FQs, both oral and
parenteral antibacterial agents, are found to be effective against gram
negative rods 7 . FQ resistance is due to mutation of genetic code for DNA gyrase
. and presence of EP preventing achievement of cytoplasmic concentration for
bactericidal action 6.Therefore EP inhibitors (EPI) have a role to play for
making FQs more effective, at least against a group of resistant bacteria,
where instead of mutation of DNA gyrase, EP is the sole mechanism of resistance


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