Abstract: OBJECTIVE In recent years, extensively drug-resistant and pandrug-resistant strains isolated in the clinic have been increasing year by year. As one of the last choices for the treatment of multidrug-resistant bacterial infections, the drug resistance of the strains to tigecycline,which belongs to semi-synthetic tetracycline drug has also appeared. The mechanisms of up-regulation of efflux pumps and plasmid-mediated transmission of drug resistance genes have been reported. Eravacycline is a new type of tetracycline drug containing a tetracyclic structure which is artificially synthesized. It can avoid the influence of classical drug resistance genes to tetracycline in many gram-negative bacteria, and has good inhibitory activity against pathogens in vitro. However, some strains are still drug-resistant to eravacycline. Therefore, it is very necessary to comprehensively elaborate the occurrence mechanism of the drug resistance to eravacycline for the further study. Clinical monitoring should be strengthened to control the spread of drug-resistant strains to eravacycline, and more targeted treatment of the infection should be administered.