TY  - JOUR
T1  - Antibiotic Dosing as an Evolutionary Intervention: A Pharmacokinetic–Pharmacodynamic Theory Linking Bacterial Killing, Resistant Subpopulation Amplification, and Post-Treatment Ecological Recovery
A1  - Grace Wanjiru
A1  - Thomas Mwangi
A1  - Samuel Adeyemi
A1  - Rajiv Menon
JF  - International Journal of Pharmaceutical Research and Allied Sciences
JO  - Int J Pharm Res Allied Sci
SN  - 2277-3657
Y1  - 2026
VL  - 15
IS  - 4
DO  - 10.51847/ShaLknJG4i
SP  - 141
EP  - 151
N2  - Antibiotic dosing is routinely evaluated through drug exposure, bacterial suppression, and clinical response, whereas evolutionary consequences may emerge across different populations and timescales. A regimen can reduce the susceptible pathogen burden while enriching resistant survivors, altering commensal competition, or leaving ecological opportunities that persist after drug clearance. This original pharmacological theory proposes that antibiotic outcomes arise from the relative timing of five partially coupled processes: active exposure at microbial niches, bactericidal or growth-suppressive response, phenotypic survival and memory, heritable resistance selection, and community reassembly. Evidence from antimicrobial pharmacokinetics, experimental evolution, bacterial physiology, and gut-microbiome studies supports the relevance of these processes individually, but does not validate their proposed integration as a universal dosing rule. The theory differentiates absolute killing from changes in resistance frequency and distinguishes microbiome structural return from functional or resistome recovery. It predicts that regimens with similar summary pharmacokinetic–pharmacodynamic indices may produce different evolutionary outcomes when tissue exposure, survivor-state duration, population bottlenecks, or recovery conditions differ. Longitudinal, compartment-resolved experiments are needed before these predictions can guide clinical dosing.
UR  - https://ijpras.com/article/antibiotic-dosing-as-an-evolutionary-intervention-a-pharmacokineticpharmacodynamic-theory-linking-kwvdamiauus4f7f
ER  -