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.

预测未来是困难的，尤其是对于受众多未知因素影响的进化过程。仍然，这是药物开发人员在临床前开发过程中评估对新抗生素候选药物产生耐药性风险时所需要的。在这篇观点文章中，我们认为，通过对细菌适应性，感染动力学，水平基因转移和其他因素进行更广泛的分析，可以显着改善当今用于预测抗生素耐药性的传统方法。这将导致更明智的临床前决策，以继续或终止候选药物的开发。