Is selection relevant in the evolutionary emergence of drug resistance?

Troy Day, Silvie Huijben, Andrew F. Read

Research output: Contribution to journalReview article

37 Scopus citations


The emergence of drug-resistant pathogens is often considered a canonical case of evolution by natural selection. Here we argue that the strength of selection can be a poor predictor of the rate of resistance emergence. It is possible for a resistant strain to be under negative selection and still emerge in an infection or spread in a population. Measuring the right parameters is a necessary first step toward the development of evidence-based resistance-management strategies. We argue that it is the absolute fitness of the resistant strains that matters most and that a primary determinant of the absolute fitness of a resistant strain is the ecological context in which it finds itself.

Original languageEnglish (US)
Pages (from-to)126-133
Number of pages8
JournalTrends in Microbiology
Issue number3
StatePublished - Jan 1 2015
Externally publishedYes



  • Antibiotics
  • Chemotherapy
  • Evolutionary rescue
  • Mutant selection window

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)
  • Infectious Diseases
  • Virology

Cite this