antibioticabewaking

Antibiotic awakening, occasionally written as antibioticabewaking, is a term used in microbiology to describe processes in which exposure to antibiotics leads to the resumption of growth or metabolic activity by cells that had been dormant, slowed, or stressed. The concept is not universally standardized, and in many studies the phenomenon is discussed under related ideas such as persistence, tolerance, or resuscitation of dormant cells.

The underlying mechanisms are diverse and often context dependent. Dormant or “sleeping” cells can survive antibiotic exposure and later re-enter active growth when the drug concentration drops or environmental conditions change. Stress responses, metabolic reprogramming, and alterations in gene expression can promote awakening. In biofilms, heterogeneous microenvironments create subpopulations with variable susceptibility, and some cells may awaken after initial antibiotic exposure, contributing to relapse. Additionally, antibiotics can induce mutagenesis or selective enrichment of tolerant phenotypes, which may appear as awakening at the population level.

Clinical relevance varies by organism and infection type. Awakening of dormant cells can complicate treatment, potentially leading to relapse and chronic infection if regimens are not sufficient to eradicate all active bacteria. This has motivated research into strategies that target persister cells, disrupt biofilms, or employ combination therapies and dosing schemes designed to minimize regrowth after antibiotic exposure.

Research status and terminology remain debated. The term antibiotic awakening is used variably, and clearer definitions are needed to distinguish awakening from the selection of preexisting tolerant cells. Further work aims to identify reliable biomarkers and develop therapies that counteract awakening mechanisms.

See also: persister cells, antibiotic tolerance, viable but nonculturable states, biofilms.