The path of least resistance: Aggressive or moderate treatment?

Roger D. Kouyos; C. Jessica E. Metcalf; Ruthie Birger; Eili Y. Klein; Pia Abel zur Wiesch; Peter Ankomah; Nimalan Arinaminpathy; Tiffany L. Bogich; Sebastian Bonhoeffer; Charles Brower; Geoffrey Chi-Johnston; Ted Cohen; Troy Day; Bryan Greenhouse; Silvie Huijben; Joshua Metlay; Nicole Mideo; Laura C. Pollitt; Andrew F. Read; David L. Smith; Claire Standley; Nina Wale; Bryan Grenfell

doi:10.1098/rspb.2014.0566

The path of least resistance: Aggressive or moderate treatment?

Roger D. Kouyos, C. Jessica E. Metcalf, Ruthie Birger, Eili Y. Klein, Pia Abel zur Wiesch, Peter Ankomah, Nimalan Arinaminpathy, Tiffany L. Bogich, Sebastian Bonhoeffer, Charles Brower, Geoffrey Chi-Johnston, Ted Cohen, Troy Day, Bryan Greenhouse, Silvie Huijben, Joshua Metlay, Nicole Mideo, Laura C. Pollitt, Andrew F. Read, David L. SmithClaire Standley, Nina Wale, Bryan Grenfell

Research output: Contribution to journal › Review article › peer-review

69 Scopus citations

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.

Original language	English (US)
Article number	20140566
Journal	Proceedings of the Royal Society B: Biological Sciences
Volume	281
Issue number	1794
DOIs	https://doi.org/10.1098/rspb.2014.0566
State	Published - Sep 24 2014

All Science Journal Classification (ASJC) codes

General Immunology and Microbiology
General Environmental Science
General Biochemistry, Genetics and Molecular Biology
General Agricultural and Biological Sciences

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10.1098/rspb.2014.0566

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Kouyos, R. D., Metcalf, C. J. E., Birger, R., Klein, E. Y., zur Wiesch, P. A., Ankomah, P., Arinaminpathy, N., Bogich, T. L., Bonhoeffer, S., Brower, C., Chi-Johnston, G., Cohen, T., Day, T., Greenhouse, B., Huijben, S., Metlay, J., Mideo, N., Pollitt, L. C., Read, A. F., ... Grenfell, B. (2014). The path of least resistance: Aggressive or moderate treatment? Proceedings of the Royal Society B: Biological Sciences, 281(1794), Article 20140566. https://doi.org/10.1098/rspb.2014.0566

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title = "The path of least resistance: Aggressive or moderate treatment?",

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.",

author = "Kouyos, {Roger D.} and Metcalf, {C. Jessica E.} and Ruthie Birger and Klein, {Eili Y.} and {zur Wiesch}, {Pia Abel} and Peter Ankomah and Nimalan Arinaminpathy and Bogich, {Tiffany L.} and Sebastian Bonhoeffer and Charles Brower and Geoffrey Chi-Johnston and Ted Cohen and Troy Day and Bryan Greenhouse and Silvie Huijben and Joshua Metlay and Nicole Mideo and Pollitt, {Laura C.} and Read, {Andrew F.} and Smith, {David L.} and Claire Standley and Nina Wale and Bryan Grenfell",

year = "2014",

month = sep,

day = "24",

doi = "10.1098/rspb.2014.0566",

language = "English (US)",

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journal = "Proceedings of the Royal Society B: Biological Sciences",

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publisher = "Royal Society of London",

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Kouyos, RD, Metcalf, CJE, Birger, R, Klein, EY, zur Wiesch, PA, Ankomah, P, Arinaminpathy, N, Bogich, TL, Bonhoeffer, S, Brower, C, Chi-Johnston, G, Cohen, T, Day, T, Greenhouse, B, Huijben, S, Metlay, J, Mideo, N, Pollitt, LC, Read, AF, Smith, DL, Standley, C, Wale, N & Grenfell, B 2014, 'The path of least resistance: Aggressive or moderate treatment?', Proceedings of the Royal Society B: Biological Sciences, vol. 281, no. 1794, 20140566. https://doi.org/10.1098/rspb.2014.0566

TY - JOUR

T1 - The path of least resistance

T2 - Aggressive or moderate treatment?

AU - Kouyos, Roger D.

AU - Metcalf, C. Jessica E.

AU - Birger, Ruthie

AU - Klein, Eili Y.

AU - zur Wiesch, Pia Abel

AU - Ankomah, Peter

AU - Arinaminpathy, Nimalan

AU - Bogich, Tiffany L.

AU - Bonhoeffer, Sebastian

AU - Brower, Charles

AU - Chi-Johnston, Geoffrey

AU - Cohen, Ted

AU - Day, Troy

AU - Greenhouse, Bryan

AU - Huijben, Silvie

AU - Metlay, Joshua

AU - Mideo, Nicole

AU - Pollitt, Laura C.

AU - Read, Andrew F.

AU - Smith, David L.

AU - Standley, Claire

AU - Wale, Nina

AU - Grenfell, Bryan

PY - 2014/9/24

Y1 - 2014/9/24

N2 - 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.

AB - 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.

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AN - SCOPUS:84908138374

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JO - Proceedings of the Royal Society B: Biological Sciences

JF - Proceedings of the Royal Society B: Biological Sciences

IS - 1794

M1 - 20140566

ER -

The path of least resistance: Aggressive or moderate treatment?

Abstract

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