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Can drug resistance evolution be reversed in the real world? The data say “Yes, we can!”
Document de travail   Open Access

Can drug resistance evolution be reversed in the real world? The data say “Yes, we can!”

Pleuni Pennings
03/2026

Résumé

resistance antimicrobial resistance plasmodium HIV evolution reversal fitness costs public health Bacteria
This perspective provides an overview of what we know from real-world data on reversal of drug resistance evolution. An important question for those who study drug resistance is whether it is possible to reverse the evolution of resistance, for example by halting the use of specific drugs for a patient or even a community or country. Evidence for successful reversal of resistance levels is spread out in many different sub-fields of infectious disease. I use examples from P. falciparum malaria, several bacterial species including E. coli, M. tuberculosis and S. aureus, and the viral pathogen HIV, to show that it is possible to reverse the evolution of resistance.

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