The spread of antibiotic resistance is a global challenge that is fueled by evolution and ecological processes. Therefore, the design of new sustainable therapy should take account of these underlying processes-as proposed within the field of evolutionary medicine, yet usually not receiving the necessary attention from national and international health agencies. We here put the spotlight on a currently neglected treatment strategy: sequential therapy. Changes among antibiotics generate fluctuating selection conditions that are in general difficult to counter by any organism. We argue that sequential treatment designs can be specifically optimized by exploiting evolutionary trade-offs, for example collateral sensitivity and/or inducible physiological constraints, such as negative hysteresis, where pre-exposure to one antibiotic induces temporary hyper-sensitivity to another antibiotic. Our commentary provides an overview of sequential treatment strategies and outlines steps towards their further optimization.

中文翻译：

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进化生态学遇到了抗生素危机：我们可以通过序贯治疗来控制病原体适应性吗？

抗生素抗性的扩散是一项全球挑战，进化和生态进程助长了这一挑战。因此，新的可持续疗法的设计应考虑到进化医学领域中提出的这些基本过程，但通常不会得到国家和国际卫生机构的必要重视。在这里，我们将重点放在当前被忽视的治疗策略上：序贯治疗。抗生素之间的变化会产生波动的选择条件，通常任何生物都难以应对。我们认为，可以通过利用进化的权衡，例如附带的敏感性和/或可诱导的生理限制，例如负滞后，来对顺序治疗设计进行特别优化。预先接触一种抗生素会引起对另一种抗生素的暂时超敏反应。我们的评论概述了顺序治疗策略并概述了进一步优化它们的步骤。