ABSTRACT
A major problem in medicine is antibiotic resistance: as bacteria evolve resistance to antibiotics, the effectiveness of this essential treatment soon declines. This chapter begins with a new treatment designed to inhibit the evolution of resistance with (bacterio)phages, viruses that attack bacteria. In adapting to a specific type of phage, the bacteria are forced to evolve less resistance to antibiotics. Bacteria that cannot be resistant to both the phage and antibiotics are an example of a tradeoff, a fundamental concept in evolution. The chapter then discusses other ways of using evolutionary principles to limit the evolution of antibiotic resistance. The applications of evolution to antibiotic resistance are a subset of the larger field of evolutionary medicine. A central question within evolutionary medicine is why we get sick and remain vulnerable to disease. Some explanations include the more rapid evolution of pathogens and parasites compared to our own, that some symptoms of illness (such as fever) are actually defenses against infectious disease, mismatches between the environments we live in and those our ancestors evolved in, and that natural selection favors traits that enhance reproduction and not necessarily our health or our happiness.
