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Selection and evolution of resistance to antimicrobial drugs
Author(s) -
Hughes Diarmaid
Publication year - 2014
Publication title -
iubmb life
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.132
H-Index - 113
eISSN - 1521-6551
pISSN - 1521-6543
DOI - 10.1002/iub.1278
Subject(s) - antibiotics , antibiotic resistance , resistance (ecology) , stewardship (theology) , drug resistance , selection (genetic algorithm) , biology , drug discovery , microbiology and biotechnology , risk analysis (engineering) , business , genetics , bioinformatics , computer science , ecology , political science , artificial intelligence , politics , law
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