Journal
MICROBIAL DRUG RESISTANCE
Volume 19, Issue 2, Pages 73-87Publisher
MARY ANN LIEBERT, INC
DOI: 10.1089/mdr.2012.0115
Keywords
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Funding
- Bayer
- Boehringer-Ingelheim
- Stendhal
- Pfizer
- MSD
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The emergence and spread of antibiotic-resistant bacteria reflects both, a gradual, completely Darwinian evolution, which mostly yields slight decreases in antibiotic susceptibility, along with phenotypes that are not precisely characterized as resistance; and sudden changes, from full susceptibility to full resistance, which are driven by a vast array of horizontal gene transfer mechanisms. Antibiotics select for more than just antibiotic resistance (i.e., increased virulence and enhanced gene exchange abilities); and many non-antibiotic agents or conditions select for or maintain antibiotic resistance traits as a result of a complex network of underlying and often overlapping mechanisms. Thus, the development of new antibiotics and thoughtful, integrated anti-infective strategies is needed to address the immediate and long-term threat of antibiotic resistance. Since the biology of resistance is complex, these new drugs and strategies will not come from free-market forces, or from incentives for pharmaceutical companies.
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