Modelling the effect of a dengue vaccine on reducing the evolution of resistance against antibiotic due to misuse in dengue cases

Abstract

Background This paper intends to check whether and how a hypothetical dengue vaccine could contribute to issue of evolution of bacteria resistance against antibiotics by reducing the number of patients that would inappropriately being treated with antibiotics. Methods We use a new mathematical model that combines, in a novel way, two previously published papers, one on the evolution of resistance against antibiotics and one classical Ross-Macdonald model for dengue transmission. Results The model is simulated numerically and reproduces a real case of evolution of resistance against antibiotics. In addition the model shows that the use of a hypothetical dengue vaccine could help to curb the evolution of resistance against an antibiotic inappropriately used in dengue patients. Both the increase in the proportion of resistant bacteria due to the misuse of antibiotics in dengue cases as a function of the fraction of treated patients and the reduction of that proportion as a function of vaccination coverage occur in a highly non-linear fashion. Conclusion The use of a dengue vaccine is helpful in reducing the rate of evolution of antibiotic resistance in a scenario of misuse of the antibiotics in dengue patients.

Dengue vaccine development by the year 2020: challenges and prospects

“…The primary need for a dengue vaccine as a public health tool is the unpredictable nature of dengue outbreaks overwhelming already existing fragile health care systems, the extremely high annual incidence of at least 100 million cases and the epidemic trajectory which shows a relentless increase over the past two decades [ 2 • , 5 , 6 ]. Dengue infections in the communities, and even hospitalized dengue, lead to inappropriate antibiotic use in more than 30%of cases [ 7 ]. Dengue has also become a leading problem in international travelers [ 8 , 9 , 10 , 11 , 12 ].…”

COVID-19 will further exacerbate global antimicrobial resistance

“…2 Similar to other viral diseases such as dengue, COVID-19 patients present with undifferentiated fever and respiratory conditions that may be empirically treated as bacterial upper respiratory infections (URTI). 3 Inappropriate use of antibiotics may be worsened, or even considered reasonable when patients' conditions deteriorate around day 8-12 of the illness. 2 Furthermore, COVID-19 patients who are critically ill often require prolonged hospitalisation associated with nosocomial bacterial infections where antibiotics are needed.…”