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Collateral sensitivity-harnessing microbial vulnerabilities as a solution to antimicrobial resistance.

Rishav Jana·Priyanka Bhowmik
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Abstract

Bacteria exhibit an evolutionary trade-off through their development of collateral sensitivity (CS) which allows them to resist one antibiotic while becoming more vulnerable to another. This vulnerability offers a compelling therapeutic opportunity by selecting against resistant isolates. Laboratory evolution studies, genome sequencing, deep mutagenesis and use of artificial intelligence and machine learning can design the bespoke strategy against multi-drug-resistant bacteria. This review discusses about recent studies that are rationally designed to harness this evolutionary trade-off for the development of alternative antimicrobial strategies. The translational barriers to the clinical implementation of CS are addressed and evidence-based design principles for optimization of CS-guided therapy are discussed.

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BacteriaAnti-Bacterial AgentsHumansDrug Collateral SensitivityDrug Resistance, BacterialDrug Resistance, Multiple, BacterialMicrobial Sensitivity TestsAntibiotic resistanceAntimicrobial therapyBacterial evolutionCollateral sensitivityEvolutionary trade-offJournal ArticleReview

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Rishav Jana, Priyanka Bhowmik. 2026-09-16. Collateral sensitivity-harnessing microbial vulnerabilities as a solution to antimicrobial resistance.. https://doi.org/10.1007/s11033-026-12752-4

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