Antibiotic cycling versus mixing: The difficulty of using mathematicalmodels to definitively quantify their relative merits
We ask the question Which antibiotic deployment protocols select best against drug-resistant microbes: mixing or periodic cycling? and demonstrate that the statistical distribution of the performances of both sets of protocols, mixing and periodic cycling, must have overlapping supports. In other w...
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AIMS Press
2010-09-01
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| Series: | Mathematical Biosciences and Engineering |
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| Online Access: | https://www.aimspress.com/article/doi/10.3934/mbe.2010.7.923 |
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| author | Robert E. Beardmore Rafael Peña-Miller |
| author_facet | Robert E. Beardmore Rafael Peña-Miller |
| author_sort | Robert E. Beardmore |
| collection | DOAJ |
| description | We ask the question Which antibiotic deployment protocols select best against drug-resistant microbes: mixing or periodic cycling? and demonstrate that the statistical distribution of the performances of both sets of protocols, mixing and periodic cycling, must have overlapping supports. In other words, it is a general, mathematical result that there must be mixing policies that outperform cycling policies and vice versa. As a result, we agree with the tenet of Bonhoefer et al. [1] that one should not apply the results of [2] to conclude that an antibiotic cycling policy that implements cycles of drug restriction and prioritisation on an ad-hoc basis can select against drug-resistant microbial pathogens in a clinical setting any better than random drug use. However, nor should we conclude that a random, per-patient drug-assignment protocol is the de facto optimal method for allocating antibiotics to patients in any general sense. |
| format | Article |
| id | doaj-art-9ef16cfd7cdf4f37af2722d7d278b996 |
| institution | Kabale University |
| issn | 1551-0018 |
| language | English |
| publishDate | 2010-09-01 |
| publisher | AIMS Press |
| record_format | Article |
| series | Mathematical Biosciences and Engineering |
| spelling | doaj-art-9ef16cfd7cdf4f37af2722d7d278b9962025-01-24T02:00:59ZengAIMS PressMathematical Biosciences and Engineering1551-00182010-09-017492393310.3934/mbe.2010.7.923Antibiotic cycling versus mixing: The difficulty of using mathematicalmodels to definitively quantify their relative meritsRobert E. Beardmore0Rafael Peña-Miller1Department of Mathematics, Imperial College London, SW7 2AZ, LondonDepartment of Mathematics, Imperial College London, SW7 2AZ, LondonWe ask the question Which antibiotic deployment protocols select best against drug-resistant microbes: mixing or periodic cycling? and demonstrate that the statistical distribution of the performances of both sets of protocols, mixing and periodic cycling, must have overlapping supports. In other words, it is a general, mathematical result that there must be mixing policies that outperform cycling policies and vice versa. As a result, we agree with the tenet of Bonhoefer et al. [1] that one should not apply the results of [2] to conclude that an antibiotic cycling policy that implements cycles of drug restriction and prioritisation on an ad-hoc basis can select against drug-resistant microbial pathogens in a clinical setting any better than random drug use. However, nor should we conclude that a random, per-patient drug-assignment protocol is the de facto optimal method for allocating antibiotics to patients in any general sense.https://www.aimspress.com/article/doi/10.3934/mbe.2010.7.923antibiotic mixingepidemiologydrug resistance.antibiotic cycling |
| spellingShingle | Robert E. Beardmore Rafael Peña-Miller Antibiotic cycling versus mixing: The difficulty of using mathematicalmodels to definitively quantify their relative merits Mathematical Biosciences and Engineering antibiotic mixing epidemiology drug resistance. antibiotic cycling |
| title | Antibiotic cycling versus mixing: The difficulty of using mathematicalmodels to definitively quantify their relative merits |
| title_full | Antibiotic cycling versus mixing: The difficulty of using mathematicalmodels to definitively quantify their relative merits |
| title_fullStr | Antibiotic cycling versus mixing: The difficulty of using mathematicalmodels to definitively quantify their relative merits |
| title_full_unstemmed | Antibiotic cycling versus mixing: The difficulty of using mathematicalmodels to definitively quantify their relative merits |
| title_short | Antibiotic cycling versus mixing: The difficulty of using mathematicalmodels to definitively quantify their relative merits |
| title_sort | antibiotic cycling versus mixing the difficulty of using mathematicalmodels to definitively quantify their relative merits |
| topic | antibiotic mixing epidemiology drug resistance. antibiotic cycling |
| url | https://www.aimspress.com/article/doi/10.3934/mbe.2010.7.923 |
| work_keys_str_mv | AT robertebeardmore antibioticcyclingversusmixingthedifficultyofusingmathematicalmodelstodefinitivelyquantifytheirrelativemerits AT rafaelpenamiller antibioticcyclingversusmixingthedifficultyofusingmathematicalmodelstodefinitivelyquantifytheirrelativemerits |