Prediction of antibiotic resistance: time for a new preclinical paradigm?

Nat Rev Microbiol. 2017 Nov;15(11):689-696. doi: 10.1038/nrmicro.2017.75. Epub 2017 Jul 31.


Predicting the future is difficult, especially for evolutionary processes that are influenced by numerous unknown factors. Still, this is what is required of drug developers when they assess the risk of resistance arising against a new antibiotic candidate during preclinical development. In this Opinion article, we argue that the traditional procedures that are used for the prediction of antibiotic resistance today could be markedly improved by including a broader analysis of bacterial fitness, infection dynamics, horizontal gene transfer and other factors. This will lead to more informed preclinical decisions for continuing or discontinuing the development of drug candidates.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Bacteria / drug effects*
  • Bacteria / genetics
  • Drug Evaluation, Preclinical
  • Drug Resistance, Multiple, Bacterial / genetics*
  • Evolution, Molecular
  • Gene Transfer, Horizontal
  • Host-Pathogen Interactions
  • Humans


  • Anti-Bacterial Agents