Smooth-and rough-colony variants of Mycobacterium avium serovar 4 were treated with three classes of drugs. The drugs were chosen for their potential inhibitory effects on the biosynthesis of the cell envelopeassociated serovar-specific glycopeptidolipid antigens. Growth was monitored radiometrically with a BACTEC 460-TB instrument, and MICs were determined for each drug. Both variants were then treated with inhibitory drugs in combination with antimicrobial agents that have demonstrated effectiveness against M. avium. No growth inhibition was observed with 6-fluoro-6-deoxy-D-glucose or avidin. Inhibitors of glycosylation, i.e., 2-deoxy-D-glucose, bacitracin, and ethambutol, were inhibitory to smooth-and rough-colony variants, whereas drugs that inhibit peptide synthesis, i.e., N-carbamyl-L-isoleucine and m-fluoro-phenylalanine, were more inhibitory for the rough-colony variant. Cerulenin, which affects fatty acid synthesis, was inhibitory for both variants, but it appeared to be more effective at inhibiting the growth of the smooth-colony variant at equivalent concentrations. Generally, when inhibitors of glycosylation were used with sparfloxacin and amikacin, a synergistic effect was observed for only the smooth variant. When drugs that affect peptide synthesis were used in combination with amikacin, a synergistic effect was observed for the rough variant, and when cerulenin was used in combination with sparfloxacin or amikacin, a synergistic effect was observed for both variants. Lipid analysis revealed that although the rough variant lacks the serovar-specific glycopeptidolipid antigens, it does possess a group of phenylalanine-isoleucine-containing lipopeptides that may explain its different susceptibility patterns to m-fluoro-phenylalanine and N-carbamyl-L-isoleucine. The significance of these results is discussed with reference to various components in the cell envelope and their importance in cell wall permeability.The new emphasis of the National Institute of Allergy and Infectious Diseases is "to spark efforts" to better understand the opportunistic infections associated with AIDS so that new and effective treatments can be developed (45). A major obstacle preventing the development of better therapies for those opportunistic pathogens is a "basic lack of knowledge about the pathogens that cause such diseases" (45). The Mycobacterium avium complex represents one of the most important groups of opportunistic pathogens infecting patients with AIDS (23,45 Rastogi et al. (33) proposed that a polysaccharide outer layer may be responsible for the impermeability of smoothtransparent variants to various substrates and drugs and also increased pathogenicity. The presence of the fibrillar material described by Draper (13) and Kim et al. (21) and later referred to as the superficial L, layer (2) may also be important as a barrier because of the polar glycopeptidolipids (GPLs) that make up its superficial location (4, 6, 44). Crowle et al. (9) suggested that both the polysaccharide layer (32, 33) and the GPL layer...