PerspectiveInfectious Disease

Why tolerance invites resistance

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Science  24 Feb 2017:
Vol. 355, Issue 6327, pp. 796
DOI: 10.1126/science.aam7926

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Bacteria use two strategies to avoid being killed by antibiotics: resistance and tolerance. Resistance mechanisms such as destruction of a drug or modification of its target allow bacteria to grow in the presence of antibiotics. Tolerance is a property of dormant, nongrowing bacterial cells in which antibiotic targets are inactive, allowing bacteria to survive. The two phenomena are mechanistically distinct and assumed to be unrelated. On page 826 of this issue, Levin-Reisman et al. (1) show that tolerance nevertheless leads to resistance.