Whenever an antibiotic is used, a selective pressure is applied that affects the interactions and competitions of the microbial populations in contact with the antibiotic. Due to selectively advantageous mutations or to the acquisition of resistance determinants by horizontal transfer, antibiotic resistance in the affected microbial populations can be expected to increase following this selective pressure. Moreover, the emergence of multidrug resistance can be expected because of this selective pressure. However, the long-term impacts of these changes in the resistant and susceptible microbial populations are unclear. Many of the resistance mechanisms can persist in the absence of an obvious selection
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