Insufficient development of new antibiotics and the rising resistance of bacteria to those that we have are putting the world at risk of losing the most widely curative class of medicines currently available. Preventing deaths from antimicrobial resistance (AMR) will require exploiting emerging knowledge not only about genetic AMR conferred by horizontal gene transfer or de novo mutations but also about phenotypic AMR, which lacks a stably heritable basis. This Review summarizes recent advances and continuing limitations in our understanding of AMR and suggests approaches for combating its clinical consequences, including identification of previously unexploited bacterial targets, new antimicrobial compounds, and improved combination drug regimens.

新抗生素开发不足以及细菌对现有抗生素的耐药性不断增强，使世界面临失去目前可用的最广泛治疗药物的风险。预防抗菌素耐药性 (AMR) 导致的死亡需要利用新兴知识，不仅需要利用水平基因转移或从头突变所赋予的遗传 AMR 知识，还需要利用缺乏稳定遗传基础的表型 AMR 知识。这篇综述总结了我们对 AMR 理解的最新进展和持续的局限性，并提出了应对其临床后果的方法，包括识别以前未开发的细菌靶点、新的抗菌化合物和改进的联合药物治疗方案。