Antimicrobial drug resistance: “Prediction is very difficult especially about the future”.

Evolution of bacterial resistance to antimicrobial drugs is unavoidable. The only means of dealing with it is to delay emergence and subsequent dissemination of resistant bacteria or resistance genes. Resistance to antimicrobials can result from mutations in housekeeping structural or regulatory genes, or horizontal acquisition of foreign genetic information. The two phenomena are not mutually exclusive and can be associated in the emergence and more efficient spread of resistance. This review discusses the predictable future of the relationship between antimicrobial drugs and bacteria. Emerging Infectious Diseases 2005;11:1503-6.