title: Antibiotic resistance: from Darwin to Lederberg to Keynes.
abstract: 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.
authors.affiliation: Fundación Lusara, Mexico City, Mexico. carlos.amabile@lusara.org
authors.forename: Carlos F
authors.initials: CF
authors.lastname: Amábile-Cuevas
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D005075:Biological Evolution; D004251:DNA Transposable Elements; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects / Q000235:genetics*; D022761:Gene Transfer, Horizontal; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000235:genetics* / Q000378:metabolism; D006094:Gram-Positive Bacteria / Q000187:drug effects / Q000235:genetics* / Q000378:metabolism; D006801:Humans; D012641:Selection, Genetic / Q000187:drug effects / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D004251:DNA Transposable Elements