Book contents
- Frontmatter
- Contents
- Contributing Authors
- List of Boxes
- Notational Standards
- 1 Introduction
- A Setting the Stage
- B Host Population Structure
- C Within-Host Interactions
- D Pathogen–Host Coevolution
- E Multilevel Selection
- F Vaccines and Drugs
- Introduction to Part F
- 23 Managing Antibiotic Resistance: What Models Tell Us?
- 24 Evolution of Vaccine-resistant Strains of Infectious Agents
- 25 Pathogen Evolution: The Case of Malaria
- 26 Vaccination and Serotype Replacement
- G Perspectives for Virulence Management
- References
- Index
- International Institute for Applied Systems Analysis
23 - Managing Antibiotic Resistance: What Models Tell Us?
Published online by Cambridge University Press: 15 January 2010
- Frontmatter
- Contents
- Contributing Authors
- List of Boxes
- Notational Standards
- 1 Introduction
- A Setting the Stage
- B Host Population Structure
- C Within-Host Interactions
- D Pathogen–Host Coevolution
- E Multilevel Selection
- F Vaccines and Drugs
- Introduction to Part F
- 23 Managing Antibiotic Resistance: What Models Tell Us?
- 24 Evolution of Vaccine-resistant Strains of Infectious Agents
- 25 Pathogen Evolution: The Case of Malaria
- 26 Vaccination and Serotype Replacement
- G Perspectives for Virulence Management
- References
- Index
- International Institute for Applied Systems Analysis
Summary
Introduction
The rapid ascent of antibiotic resistance is cause for great concern in public health. Resistant bacteria not only compromise the success of treatment, but can also be transmitted and cause an epidemic of resistant organisms. In hospitals, antibiotic resistance is commonly observed in organisms such as Streptococcus pneumoniae (Doern et al. 1996), Neisseria gonorrhoeae (Cohen 1994), and Mycobacterium tuberculosis (Bloom and Murray 1992), as well as in nosocomial pathogens including Staphylococcus aureus (Swartz 1994), Enterococcus spp. (Swartz 1994; Arthur and Courvalin 1993), and Klebsiella spp. (Jacoby 1996). At the same time, the development of new antibiotic agents is becoming increasingly difficult and costly.
Antibiotics, therefore, must be seen as a limited resource in our efforts to control and cure bacterial infections. This raises the question of how to use existing antibiotics with maximal effect to treat bacterial infections while simultaneously reversing or delaying the emergence of resistance. A number of measures have been proposed to counteract the evolution of resistance, including the improvement of hospital hygiene (Murray 1994), the possible use of vaccines (Jernigan et al. 1996), tighter controls on antibiotic use in clinical practice as well as agriculture (Anonymous 1995), and alternative patterns of antibiotic use such as sequential cycling of antibiotics or combination therapy (Swartz 1994; McGowan 1986).
These measures are not mutually exclusive, and an effective plan for the future use of antibiotics must consider how they should be combined.
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- Chapter
- Information
- Adaptive Dynamics of Infectious DiseasesIn Pursuit of Virulence Management, pp. 326 - 338Publisher: Cambridge University PressPrint publication year: 2002
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