Antibiotic resilience: a necessary concept to complement antibiotic resistance?

Area of Science:

• Ecology
• Microbiology
• Clinical Bacteriology

Background:

• Resilience and resistance are key ecological concepts for ecosystem stability.
• Antibiotic resistance is a major clinical problem, but antibiotic resilience is underutilized.
• Existing microbiological concepts like tolerance and persistence relate to resilience.

Purpose of the Study:

• To bridge ecological and clinical bacteriology by exploring antibiotic resilience.
• To define antibiotic resilience in a clinical context.
• To identify measurable indicators for antibiotic resilience.

Main Methods:

• Reviewing the concept of resilience in ecology, socio-ecological systems, and microbiology.
• Examining related microbiological concepts: bacterial tolerance, persistence, phenotypic heterogeneity, and collective resistance.
• Discussing the definition, experimental measurement, and clinical relevance of antibiotic resilience.

Main Results:

• Resilience is the capacity of systems to recover function after disturbance.
• Several microbiological concepts are related to bacterial resilience.
• Defining and measuring antibiotic resilience is key to its clinical application.

Conclusions:

• Antibiotic resilience offers a new perspective on bacterial response to antibiotics.
• Experimental measures and clinical relevance are essential for applying the concept of antibiotic resilience.
• Indicators of antibiotic resilience can predict bacterial recovery from antibiotic treatments.