A model-guided analysis and perspective on the evolution and epidemiology of antibiotic resistance and its future

• Type of Material: Article
• Authors: Bruce Levin, Emory University; Fernando Baquero, Ramón y Cajal University Hospital; Pal J. Johnsen, The Arctic University of Norway
• Language: English
• Date: 2014-01-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 Elsevier Ltd.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.mib.2014.06.004
• Title of Journal or Parent Work: Current Opinion in Microbiology
• ISSN: 1369-5274
• Volume: 19
• Issue: 1
• Start Page: 83
• End Page: 89
• Grant/Funding Information: PJJ is funded by the Norwegian Research Council grant 204263.; BRL wishes to acknowledge support from the US National Institute of Health, GM 091875. FB laboratory is sponsored by European Union (EvoTAR-282004), and Spain (FIS-PI12-01581 and PROMPT-S2010/BMD2414) Research Grants.
• Keywords: Humans; Anti-Bacterial Agents; Biological Evolution; Models, Theoretical; Drug Resistance, Microbial
• Research Categories: Biology, Virology; Health Sciences, Epidemiology

Abstract

A simple epidemiological model is used as a framework to explore the potential efficacy of measures to control antibiotic resistance in community-based self-limiting human infections. The analysis of the properties of this model predict that resistance can be maintained at manageable levels if: first, the rates at which specific antibiotics are used declines with the frequency of resistance to these drugs; second, resistance rarely emerges during therapy; and third, external sources rarely contribute to the entry of resistant bacteria into the community. We discuss the feasibility and limitations of these measures to control the rates of antibiotic resistance and the potential of advances in diagnostic procedures to facilitate this endeavor.