The path of least resistance: aggressive or moderate treatment? | Zendy

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

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The path of least resistance: aggressive or moderate treatment?

Author(s) -

Roger D. Kouyos,

C. Jessica E. Metcalf,

Ruthie Birger,

Eili Klein,

Pia Abel zur Wiesch,

Pierre Ankomah,

Nimalan Arinaminpathy,

Tiffany L. Bogich,

Sebastian Bonhoeffer,

Charles Brower,

Geoffrey L. Johnston,

Ted Cohen,

Troy Day,

Bryan Greenhouse,

Silvie Huijben,

Joshua P. Metlay,

Nicole Mideo,

Laura C. Pollitt,

Andrew F. Read,

David L. Smith,

Claire J. Standley,

Nina Wale,

Bryan T. Grenfell

Publication year - 2014

Publication title -

proceedings of the royal society b biological sciences

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 2.342

H-Index - 253

eISSN - 1471-2954

pISSN - 0962-8452

DOI - 10.1098/rspb.2014.0566

Subject(s) - intensive care medicine , drug resistance , dose , resistance (ecology) , resistance factors , medicine , drug , path (computing) , risk analysis (engineering) , biology , computer science , pharmacology , engineering , ecology , structural engineering , microbiology and biotechnology , programming language

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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