A mathematical model for predicting the development of bacterial resistance based on the relationship between the level of antimicrobial resistance and the volume of antibiotic consumption

被引:21
作者
Arepyeva, M. A. [1 ]
Kolbin, A. S. [1 ,2 ]
Sidorenko, S. V. [3 ]
Lawson, R. [4 ]
Kurylev, A. A. [2 ]
Balykina, Yu E. [1 ]
Mukhina, N. V. [2 ]
Spiridonova, A. A. [2 ]
机构
[1] St Petersburg State Univ, Kollontai St, St Petersburg, Russia
[2] First Pavlov State Med Univ St Petersburg, St Petersburg, Russia
[3] Sci Res Inst Childrens Infect, St Petersburg, Russia
[4] AstraZeneca, Gaithersburg, MD USA
关键词
Antibiotic resistance; Mathematical model; Volume of antibiotic consumption; Average maintenance dose;
D O I
10.1016/j.jgar.2016.11.010
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objectives: Infections that are inadequately treated owing to acquired bacterial resistance are a leading cause of mortality. Rates of multidrug-resistant bacteria are rising, resulting in increased antibiotic failures and worsening patient outcomes. Mathematical modelling makes it possible to predict the future spread of bacterial antimicrobial resistance. The aim of this study was to construct a mathematical model that can describe the dependency between the level of antimicrobial resistance and the amount of antibiotic usage. Methods: After reviewing existing mathematical models, a cross-sectional, retrospective study was carried out to collect clinical and microbiological data across 3000 patients for the construction of the mathematical model. Based on these data, a model was developed and tested to determine the dependency between antibiotic usage and resistance. Results: Consumption of inhibitor/cephalosporins and fluoroquinolones increases inhibitor/penicillin resistance. Consumption of inhibitor/penicillins increases cephalosporin resistance. Consumption of inhibitor/penicillins increases inhibitor/cephalosporin resistance. Conclusions: It was demonstrated that in some antibiotic-micro-organism pairs, the level of antibiotic usage significantly influences the level of resistance. The model makes it possible to predict the change in resistance and also shows the quantitative effect of antibiotic consumption on the level of bacterial resistance. (C) 2017 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:148 / 156
页数:9
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