Evaluating treatment protocols to prevent antibiotic resistance

• DOI: 10.1073/pnas.94.22.12106
• Publication Date: 2002-07-26T14:40:52Z
• Authors: Sebastian Bonhoeffer; Marc Lipsitch; Bruce R. Levin
• Keywords: 0301 basic medicine; Health Policy; Drug Resistance, Microbial; Bacterial Infections; Models, Theoretical; Drug Resistance, Multiple; Anti-Bacterial Agents; 3. Good health; 03 medical and health sciences; Treatment Outcome; Clinical Protocols; Drug Therapy; Evaluation Studies as Topic; Humans; Drug Therapy, Combination

The spread of bacteria resistant to antimicrobial agents calls for population-wide treatment strategies delay or reverse the trend toward antibiotic resistance. Here we propose new criteria evaluation effects protocols directly transmitted bacterial infections and discuss different usage patterns single multiple therapy. A mathematical model suggests that long-term benefit drug from introduction until a high frequency resistance precludes its use is almost independent pattern use. When more than one employed, sequential antibiotics in population (“cycling”) always inferior where, at any given time, equal fractions receive antibiotics. However, all patients with combination most cases optimal strategy.