The Relationship between the Volume of Antimicrobial Consumption in Human Communities and the Frequency of Resistance

• Published in: Proceedings of the National Academy of Sciences - PNAS Vol. 96; no. 3; pp. 1152 - 1156
• Main Authors: Austin, D. J., Kristinsson, K. G., Anderson, R. M.
• Format: Journal Article
• Language: English
• Published: United States National Academy of Sciences of the United States of America 02.02.1999; National Acad Sciences; National Academy of Sciences; The National Academy of Sciences
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibiotics; Bacteria; Bacteria - drug effects; Bacteria - genetics; Bacteria - growth & development; Bacterial Infections - transmission; Biological Sciences; Biology; Commensals; Cross Infection - transmission; Drug resistance; Drug Resistance, Microbial - genetics; Genes, Bacterial; Genetics, Population; Genotypes; Humans; Medical sciences; Microbial colonization; Models, Biological; Models, Statistical; Population genetics; Prescription drugs; Superinfection
• ISSN: 0027-8424; 1091-6490
• DOI: 10.1073/pnas.96.3.1152

The threat to human health posed by antibiotic resistance is of growing concern. Many commensal and pathogenic organisms have developed resistance to well established and newer antibiotics. The major selection pressure driving changes in the frequency of antibiotic resistance is the volume of drug use. However, establishing a quantitative relationship between the frequency of resistance and volume of drug use has proved difficult. Using population genetic methods and epidemiological observations, we report an analysis of the influence of the selective pressure imposed by the volume of drug use on temporal changes in resistance. Analytical expressions are derived to delineate key relationships between resistance and drug consumption. The analyses indicate that the time scale for emergence of resistance under a constant selective pressure is typically much shorter than the decay time after cessation or decline in the volume of drug use and that significant reductions in resistance require equally significant reductions in drug consumption. These results highlight the need for early intervention once resistance is detected.