How competition governs whether moderate or aggressive treatment minimizes antibiotic resistance.
Author(s)
Colijn, C
Cohen, T
Type
Journal Article
Abstract
Understanding how our use of antimicrobial drugs shapes future levels of drug resistance is crucial. Recently, there has been debate over whether an aggressive (i.e., high dose) or more moderate (i.e., lower dose) treatment of individuals will most limit the emergence and spread of resistant bacteria. In this study, we demonstrate how one can understand and resolve these apparently contradictory conclusions. We show that a key determinant of which treatment strategy will perform best at the individual level is the extent of effective competition between resistant and sensitive pathogens within a host. We extend our analysis to the community level, exploring the spectrum between strict inter-strain competition and strain independence. From this perspective as well, we find that the magnitude of effective competition between resistant and sensitive strains determines whether an aggressive approach or moderate approach minimizes the burden of resistance in the population.
Date Issued
2015-09-22
Date Acceptance
2015-09-18
Citation
eLife, 2015, 4
ISSN
2050-084X
Publisher
eLife Sciences Publications
Journal / Book Title
eLife
Volume
4
Copyright Statement
Copyright Colijn and Cohen.
This article is distributed under
the terms of the Creative
Commons Attribution License,
which permits unrestricted use
and redistribution provided that
the original author and source are
credited.
This article is distributed under
the terms of the Creative
Commons Attribution License,
which permits unrestricted use
and redistribution provided that
the original author and source are
credited.
License URL
Identifier
http://www.ncbi.nlm.nih.gov/pubmed/26393685
Subjects
antibiotic
competition
drug resistance
epidemiology
global health
infectious disease
microbiology
modelling
Publication Status
Published
Coverage Spatial
England
Article Number
e10559