A potential pathway linking hydroxyl radicals to antimicrobial lethality was examined by using mutational and chemical perturbations of Escherichia coli. Deficiencies of sodA or sodB had no effect on norfloxacin lethality; however, the absence of both genes together reduced lethal activity, consistent with rapid conversion of excessive superoxide to hydrogen peroxide contributing to quinolone lethality. Norfloxacin was more lethal with a mutant deficient in katG than with its isogenic parent, suggesting that detoxification of peroxide to water normally reduces quinolone lethality. An iron chelator (bipyridyl) and a hydroxyl radical scavenger (thiourea) reduced the lethal activity of norfloxacin, indicating that norfloxacin-stimulated accumulation of peroxide affects lethal activity via hydroxyl radicals generated through the Fenton reaction. Ampicillin and kanamycin, antibacterials unrelated to fluoroquinolones, displayed behavior similar to that of norfloxacin except that these two agents showed hyperlethality with an ahpC (alkyl hydroperoxide reductase) mutant rather than with a katG mutant. Collectively, these data are consistent with antimicrobial stress increasing the production of superoxide, which then undergoes dismutation to peroxide, from which a highly toxic hydroxyl radical is generated. Hydroxyl radicals then enhance antimicrobial lethality, as suggested by earlier work. Such findings indicate that oxidative stress networks may provide targets for antimicrobial potentiation.Antimicrobials that actively kill pathogens are expected to cure disease more rapidly and restrict the emergence of resistance better than agents that are largely bacteriostatic. Consequently, considerable effort has been devoted to understanding mechanisms of lethal action. In general, antimicrobials are thought to kill microbes through interaction with specific intracellular targets, followed by corruption of particular cellular processes (22). However, Collins and associates recently proposed that many bactericidal antimicrobials also share a common lethal pathway that involves the generation/accumulation of hydroxyl radicals (13,23). This hypothesis is supported by elevated hydroxyl radical levels associated with lethal antimicrobial treatment (23). How this occurs is largely unknown.Three major reactive oxygen species, superoxide, hydrogen peroxide, and hydroxyl radical, are generated as by-products of normal aerobic respiration (17,20). All three are cytotoxic, but they display different kinetics and levels of severity. For example, the effects of superoxide and hydrogen peroxide are probably less acute than those of hydroxyl radicals, since both superoxide and hydrogen peroxide can be detoxified by induced scavenging enzymes. In contrast, no enzyme can detoxify hydroxyl radicals, making them extremely toxic and acutely lethal. Hydroxyl radicals derive from hydrogen peroxide through the Fenton reaction (14), which makes the regulation of the intracellular peroxide concentration a starting point for exploring genetic pathway...