Paper 22 August 2025

Evolutionary drivers of divergent collateral sensitivity responses during antibiotic therapy

In this review article in Nature Ecology & Evolution, we explore collateral sensitivity as a promising strategy to slow down antibiotic resistance evolution. While collateral sensitivity holds great potential, challenges remain:

• Its magnitude and sign can shift across replicate experiments, pathogens, or environments.
• Even when collateral sensitivity initially emerges, it may be lost during cycling or combination therapies, which may instead lead to multidrug resistance.

We conclude by outlining the key research directions that could unlock the full potential of CS in clinical practice.