The development of resistance to linezolid (LZD) in gram-positive bacteria depends on the mutation of a single 23S rRNA gene, followed by homologous recombination and gene conversion of the other alleles. We sought to inhibit this process in Staphylococcus aureus using a range of antibacterial agents, including some that suppress recombination. A model for the rapid selection of LZD resistance was developed which allowed the selection of LZD-resistant mutants with G2576T mutations in all five copies of the 23S rRNA gene following only 5 days of subculture. The emergence of LZD-resistant isolates was delayed by exposing cultures to low concentrations of various classes of antibiotics. All antibiotic classes were effective in delaying the selection of LZD-resistant mutants and, with the exception of fusidic acid (FUS) and rifampin (RIF), prolonged the selection window from 5 to ϳ15 days. Inhibitors of DNA processing were no more effective than any other class of antibiotics at suppressing resistance development. However, the unrelated antimicrobials FUS and RIF were particularly effective at preventing the emergence of LZD resistance, prolonging the selection window from 5 to 25 days. The enhanced suppressive effect of FUS and RIF on the development of LZD resistance was lost in a recA-deficient host, suggesting that these drugs affect recA-dependent recombination. Furthermore, FUS and RIF were shown to be effective inhibitors of homologous recombination of a plasmid into the staphylococcal chromosome. We suggest that RIF or FUS in combination with LZD may have a role in preventing the emergence of LZD resistance.The development of resistance to linezolid (LZD) in clinical isolates of Staphylococcus aureus and enterococci involves the generation of mutations in one of the multiple 23S rRNA gene copies targeted by the drug, followed by homologous recombination between the remaining 23S rRNA gene copies, i.e., a process of gene conversion (15,18,30). In addition to LZD resistance, gene conversion has also been implicated in the emergence of resistance to penicillin in pneumococci (4, 23) and, possibly, also in the emergence of resistance to macrolides in staphylococci, which, like LZD resistance, appears to result from alterations to rRNA operons (26).There has been previous interest in exploring ways in which the development or spread of resistance to an antimicrobial agent might be blocked at the genetic level, e.g., by suppressing the emergence of point mutations with antimutagenic agents, disrupting horizontal DNA transfer (5, 25, 32, 33), or promoting the curing of plasmids by chemical agents (3,16,24,32,33). However, the possibility of inhibiting gene conversion events to suppress the emergence of resistance has not been explored. We have examined a variety of antimicrobial agents, including those that inhibit DNA processing, for their ability to interfere with the development of LZD resistance in S. aureus. Spiral plating techniques, which require successive serial transfers in the presence of LZD for many we...