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Alternating antibiotic treatments constrain evolutionary paths to multidrug resistance
Open accessAbstract
Significance: Antibiotic resistance is a growing threat, but the pace of drug discovery remains slow. Combination therapy can inhibit the emergence of de novo resistance but is often too toxic for long-term use. Alternating treatments, in which drugs are used sequentially with periodic switching, have been proposed as a substitute, but it remains uncertain when and how they slow the evolution of resistance. Using experimental evolution and whole-genome sequencing, we find that alternating drugs slows the rate of increase in resistance compared with single-drug treatments, by constraining resistance mutations with trade-offs in resistance to a second drug. Thus, drug combinations can exploit these trade-offs to slow the evolution of resistance, even when the drugs are not used simultaneously.
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Metadata
- Authors
- Kim, S., Lieberman, T. D., & Kishony, R.
- Venue
- Proceedings of the National Academy of Sciences
- Published
- 2014-09-22
- Volume
- 111
- Issue
- 40
- Pages
- 14494-14499
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- OpenAlex
- W2111020219
- Cited by
- 264
- References
- 44
- FWCI
- 13.47
- Type
- journal article
- Language
- en
- Open access
- bronze
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