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2016 ; 351
(6268
): aad3292
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Multidrug evolutionary strategies to reverse antibiotic resistance
#MMPMID26722002
Baym M
; Stone LK
; Kishony R
Science
2016[Jan]; 351
(6268
): aad3292
PMID26722002
show ga
Antibiotic treatment has two conflicting effects: the desired, immediate effect
of inhibiting bacterial growth and the undesired, long-term effect of promoting
the evolution of resistance. Although these contrasting outcomes seem
inextricably linked, recent work has revealed several ways by which antibiotics
can be combined to inhibit bacterial growth while, counterintuitively, selecting
against resistant mutants. Decoupling treatment efficacy from the risk of
resistance can be achieved by exploiting specific interactions between drugs, and
the ways in which resistance mutations to a given drug can modulate these
interactions or increase the sensitivity of the bacteria to other compounds.
Although their practical application requires much further development and
validation, and relies on advances in genomic diagnostics, these discoveries
suggest novel paradigms that may restrict or even reverse the evolution of
resistance.