학술논문
The path of least resistance: aggressive or moderate treatment?
Document Type
article
Author
Kouyos, Roger D; Metcalf, C Jessica E; Birger, Ruthie; Klein, Eili Y; Wiesch, Pia Abel zur; Ankomah, Peter; Arinaminpathy, Nimalan; Bogich, Tiffany L; Bonhoeffer, Sebastian; Brower, Charles; Chi-Johnston, Geoffrey; Cohen, Ted; Day, Troy; Greenhouse, Bryan; Huijben, Silvie; Metlay, Joshua; Mideo, Nicole; Pollitt, Laura C; Read, Andrew F; Smith, David L; Standley, Claire; Wale, Nina; Grenfell, Bryan
Source
Proceedings of the Royal Society B. 281(1794)
Subject
Language
Abstract
The evolution of resistance to antimicrobial chemotherapy is a major and growing cause of human mortality and morbidity. Comparatively little attention has been paid to how different patient treatment strategies shape the evolution of resistance. In particular, it is not clear whether treating individual patients aggressively with high drug dosages and long treatment durations, or moderately with low dosages and short durations can better prevent the evolution and spread of drug resistance. Here, we summarize the very limited available empirical evidence across different pathogens and provide a conceptual framework describing the information required to effectively manage drug pressure to minimize resistance evolution.