Application of dynamic modelling techniques to the problem of antibacterial use and resistance: a scoping review

Abstract

Selective pressure exerted by the widespread use of antibacterial drugs is accelerating the development of resistant bacterial populations. The purpose of this scoping review was to summarise the range of studies that use dynamic models to analyse the problem of bacterial resistance in relation to antibacterial use in human and animal populations. A comprehensive search of the peer-reviewed literature was performed and non-duplicate articles (n = 1486) were screened in several stages. Charting questions were used to extract information from the articles included in the final subset (n = 81). Most studies (86%) represent the system of interest with an aggregate model; individual-based models are constructed in only seven articles. There are few examples of inter-host models outside of human healthcare (41%) and community settings (38%). Resistance is modelled for a non-specific bacterial organism and/or antibiotic in 40% and 74% of the included articles, respectively. Interventions with implications for antibacterial use were investigated in 67 articles and included changes to total antibiotic consumption, strategies for drug management and shifts in category/class use. The quality of documentation related to model assumptions and uncertainty varies considerably across this subset of articles. There is substantial room to improve the transparency of reporting in the antibacterial resistance modelling literature as is recommended by best practice guidelines.

Feedlot Cattle Antimicrobial Use Surveillance Network: A Canadian Journey

“…Support will be prioritized to projects that can use previously collected samples or data, or which can be conducted within the resource allocation of the existing system. For example, a current initiative funded by Genome Canada will use some of the comprehensive data from the RETROSPECTIVE study combined with genomic data from novel platforms to develop, inform and strengthen the accuracy of predictive animal health disease transmission models ( 52 , 53 ). It is hoped that the CanFASP and other Canadian feedlot cattle research can continue to support and progress initiatives such as this.…”

Informed and uninformed empirical therapy policies

“…Theoretical studies have sought to compare the performance of empirical therapy policies by using compartmental models of infections and emergence of drug resistance in health care facilities at the between-host level. We refer to [6,22] for reviews and perspectives on this topic. The emergence and spread of drug resistance is a nonlinear phenomenon that strongly depends on the parameters of the population dynamics in the health care facility and on the characteristics of the disease.…”

Surveillance based dynamic empirical therapy in a health care facility: an artificial intelligence approach

“…The theoretical investigations of empirical therapy policies typically rely on aggregate (between-host) models of the emergence and spread of antimicrobial resistance; see [17] for a review. In this line, it was shown in [10] that policies based on the results of microbiological tests could limit the spread of resistance.…”

“…See [6] for an introductory application of this method to empirical therapy optimization, and [7,8] for an application to chemotherapy regimen optimization. As for the underlying epidemiological model, our optimization method relies on the stochastic version of a compartmental model derived from those presented in [17].…”