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How competition governs whether moderate or aggressive treatment minimizes antibiotic resistance
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 bacteri...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
eLife Sciences Publications, Ltd
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4641510/ https://www.ncbi.nlm.nih.gov/pubmed/26393685 http://dx.doi.org/10.7554/eLife.10559 |
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author | Colijn, Caroline Cohen, Ted |
author_facet | Colijn, Caroline Cohen, Ted |
author_sort | Colijn, Caroline |
collection | PubMed |
description | 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. DOI: http://dx.doi.org/10.7554/eLife.10559.001 |
format | Online Article Text |
id | pubmed-4641510 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | eLife Sciences Publications, Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-46415102015-11-12 How competition governs whether moderate or aggressive treatment minimizes antibiotic resistance Colijn, Caroline Cohen, Ted eLife Epidemiology and Global Health 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. DOI: http://dx.doi.org/10.7554/eLife.10559.001 eLife Sciences Publications, Ltd 2015-09-22 /pmc/articles/PMC4641510/ /pubmed/26393685 http://dx.doi.org/10.7554/eLife.10559 Text en © 2015, Colijn and Cohen http://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use and redistribution provided that the original author and source are credited. |
spellingShingle | Epidemiology and Global Health Colijn, Caroline Cohen, Ted How competition governs whether moderate or aggressive treatment minimizes antibiotic resistance |
title | How competition governs whether moderate or aggressive treatment minimizes antibiotic resistance |
title_full | How competition governs whether moderate or aggressive treatment minimizes antibiotic resistance |
title_fullStr | How competition governs whether moderate or aggressive treatment minimizes antibiotic resistance |
title_full_unstemmed | How competition governs whether moderate or aggressive treatment minimizes antibiotic resistance |
title_short | How competition governs whether moderate or aggressive treatment minimizes antibiotic resistance |
title_sort | how competition governs whether moderate or aggressive treatment minimizes antibiotic resistance |
topic | Epidemiology and Global Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4641510/ https://www.ncbi.nlm.nih.gov/pubmed/26393685 http://dx.doi.org/10.7554/eLife.10559 |
work_keys_str_mv | AT colijncaroline howcompetitiongovernswhethermoderateoraggressivetreatmentminimizesantibioticresistance AT cohented howcompetitiongovernswhethermoderateoraggressivetreatmentminimizesantibioticresistance |