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Comparing optimization criteria in antibiotic allocation protocols

Clinicians prescribing antibiotics in a hospital context follow one of several possible ‘treatment protocols’—heuristic rules designed to balance the immediate needs of patients against the long-term threat posed by the evolution of antibiotic resistance and multi-resistant bacteria. Several criteri...

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Autores principales: Jamieson-Lane, Alastair, Friedrich, Alexander, Blasius, Bernd
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Royal Society 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8941386/
https://www.ncbi.nlm.nih.gov/pubmed/35345436
http://dx.doi.org/10.1098/rsos.220181
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author Jamieson-Lane, Alastair
Friedrich, Alexander
Blasius, Bernd
author_facet Jamieson-Lane, Alastair
Friedrich, Alexander
Blasius, Bernd
author_sort Jamieson-Lane, Alastair
collection PubMed
description Clinicians prescribing antibiotics in a hospital context follow one of several possible ‘treatment protocols’—heuristic rules designed to balance the immediate needs of patients against the long-term threat posed by the evolution of antibiotic resistance and multi-resistant bacteria. Several criteria have been proposed for assessing these protocols; unfortunately, these criteria frequently conflict with one another, each providing a different recommendation as to which treatment protocol is best. Here, we review and compare these optimization criteria. We are able to demonstrate that criteria focused primarily on slowing evolution of resistance are directly antagonistic to patient health both in the short and long term. We provide a new optimization criteria of our own, intended to more meaningfully balance the needs of the future and present. Asymptotic methods allow us to evaluate this criteria and provide insights not readily available through the numerical methods used previously in the literature. When cycling antibiotics, we find an antibiotic switching time which proves close to optimal across a wide range of modelling assumptions.
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spelling pubmed-89413862022-03-27 Comparing optimization criteria in antibiotic allocation protocols Jamieson-Lane, Alastair Friedrich, Alexander Blasius, Bernd R Soc Open Sci Mathematics Clinicians prescribing antibiotics in a hospital context follow one of several possible ‘treatment protocols’—heuristic rules designed to balance the immediate needs of patients against the long-term threat posed by the evolution of antibiotic resistance and multi-resistant bacteria. Several criteria have been proposed for assessing these protocols; unfortunately, these criteria frequently conflict with one another, each providing a different recommendation as to which treatment protocol is best. Here, we review and compare these optimization criteria. We are able to demonstrate that criteria focused primarily on slowing evolution of resistance are directly antagonistic to patient health both in the short and long term. We provide a new optimization criteria of our own, intended to more meaningfully balance the needs of the future and present. Asymptotic methods allow us to evaluate this criteria and provide insights not readily available through the numerical methods used previously in the literature. When cycling antibiotics, we find an antibiotic switching time which proves close to optimal across a wide range of modelling assumptions. The Royal Society 2022-03-23 /pmc/articles/PMC8941386/ /pubmed/35345436 http://dx.doi.org/10.1098/rsos.220181 Text en © 2022 The Authors. https://creativecommons.org/licenses/by/4.0/Published by the Royal Society under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, provided the original author and source are credited.
spellingShingle Mathematics
Jamieson-Lane, Alastair
Friedrich, Alexander
Blasius, Bernd
Comparing optimization criteria in antibiotic allocation protocols
title Comparing optimization criteria in antibiotic allocation protocols
title_full Comparing optimization criteria in antibiotic allocation protocols
title_fullStr Comparing optimization criteria in antibiotic allocation protocols
title_full_unstemmed Comparing optimization criteria in antibiotic allocation protocols
title_short Comparing optimization criteria in antibiotic allocation protocols
title_sort comparing optimization criteria in antibiotic allocation protocols
topic Mathematics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8941386/
https://www.ncbi.nlm.nih.gov/pubmed/35345436
http://dx.doi.org/10.1098/rsos.220181
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