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Selection and Evolution of Resistance to Antimicrobial Drugs
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
2014 (English)In: IUBMB Life - A Journal of the International Union of Biochemistry and Molecular Biology, ISSN 1521-6543, E-ISSN 1521-6551, Vol. 66, no 8, 521-529 p.Article, review/survey (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2014. Vol. 66, no 8, 521-529 p.
Keyword [en]
antibiotic, fluoroquinolone, rifampicin, fitness, evolution, resistance, sub-MIC
National Category
Biochemistry and Molecular Biology
Identifiers
URN: urn:nbn:se:uu:diva-235858DOI: 10.1002/iub.1278ISI: 000342671900001PubMedID: 24933583OAI: oai:DiVA.org:uu-235858DiVA: diva2:762417
Available from: 2014-11-11 Created: 2014-11-11 Last updated: 2017-12-05Bibliographically approved

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