Selection and evolution of resistance to antimicrobial drugs

Authors

  • Diarmaid Hughes

    Corresponding author
    1. Department of Medical Biochemistry and Microbiology, Biomedical Center, Uppsala University, Uppsala, Sweden
    • Address correspondence to: Diarmaid Hughes, Department of Medical Biochemistry and Microbiology, Biomedical Center, Uppsala University, Box 582, Uppsala, Sweden. E-mail: diarmaid.hughes@imbim.uu.se

    Search for more papers by this author

Abstract

The overuse and misuse of antibiotics over many years has selected a high frequency of resistance among medically important bacterial pathogens. The evolution of resistance is complex, frequently involving multiple genetic alterations that minimize biological fitness costs and/or increase the resistance level. Resistance is selected at very low drug concentrations, such as found widely distributed in the environment, and this selects for resistant mutants with a high fitness. Once resistance with high fitness is established in a community it is very difficult to reduce its frequency. Addressing the problem of resistance is essential if we are to ensure a future where we can continue to enjoy effective medical control of bacterial infections. This will require several actions including the discovery and development of novel antibiotics, the creation of a continuous pipeline of drug discovery, and the implementation of effective global antibiotic stewardship to reduce the misuse of antibiotics and their release into the environment. © 2014 IUBMB Life, 66(8):521–529, 2014

Ancillary