Toward a dynamic theory of antibiotic resistance

Abstract

Many common bacterial pathogens have become increasingly resistant to the antibiotics used to treat them. The evidence suggests that the essential cause of the problem is the extensive and often inappropriate use of antibiotics, a practice that encourages the proliferation of resistant mutant strains of bacteria while suppressing the susceptible strains. However, it is not clear to what extent antibiotic use must be reduced to avoid or reverse an epidemic of antibiotic resistance, and how early the interventions must be made to be effective. To investigate these questions, we have developed a small system dynamics model that portrays changes over a period of years to three subsets of a bacterial population— antibiotic‐susceptible, intermediately resistant, and highly resistant. The details and continuing refinement of this model are based on a case study of Streptococcus pneumoniae, a leading cause of illness and death worldwide. The paper presents the model's structure and behavior and identifies open questions for future work. Copyright © 2000 John Wiley & Sons, Ltd.

Systems Science Methods in Public Health: Dynamics, Networks, and Agents

“…Models have offered particularly powerful results when data exist to provide a test of model validity. A classic example of the use of SD in studying the dynamic of unintended consequences is provided by Homer and colleagues (69), who developed and tested a model to study the development of antibiotic resistant in pneumonia using existing population-based data from various countries. Vickers et al (143) employed SD modeling to test various assumptions for the rebound in chlamydia rates, and used surveillance data to choose the most parsimonious model whose behavior mirrored that of the surveillance data, which pointed to increased testing and not to any real increases in occurrence as the reason behind the uptick in chlamydia rates.…”

Socioeconomic determinants of regional differences in outpatient antibiotic consumption: Evidence from Switzerland

“…However, researchers suggest that almost one third of drug prescriptions are questionable (Wise et al, 1998;Homer et al, 2000).…”

Antifungal and Antibacterial Activity of Crude Stem Bark Extracts of Bersama abysinicca Verdc. and Faurea saligna Harr.

“…The development of microbial resistance to the available antibiotics has led several people to investigate the antimicrobial activities of higher medicinal plants. Bisignano et al (1996), Maoz and Neeman (1998) and Homer et al (2000). There is also increased use of plants extracts as cosmetics and pharmaceutical products, something which has generated a lot of interest in identification of active compounds.…”

“…One is overuse of antibiotics both in humans and animals and second non-compliance of patients to the courses of treatment. Both the long-term exposure to low doses and the failure to finish a prescription encourage more resistant bacterial strains to thrive (Homer et al, 2000). The universal problem of pathogen resistances to antibiotics is compounded by the emergence of opportunistic infections both fungal and bacterial infections (Seguin et al, 2006).…”