Understanding the Mechanisms and Drivers of Antimicrobial Resistance¶
Holmes, A. H., Moore, L. S. P., Sundsfjord, A., Steinbakk, M., Regmi, S., Karkey, A., Guerin, P. J., et al. (2016). Understanding the Mechanisms and Drivers of Antimicrobial Resistance. The Lancet, 387(1001), 176-187.
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Primes¶
- Overshoot and Collapse
- In physiology and medicine, oxygen and many nutrients are beneficial up to a dose and toxic beyond it, and antibiotic overuse is a textbook case: antibiotics are beneficial against infection, but overuse past the point where the susceptible population is cleared selects for resistance (the self-amplifying inversion), depleting the effective-drug reserve — the secondary resource — and the resistant regime is hysteretic, persisting in the bacterial population long after the antibiotic is withdrawn.
This sourceAntimicrobial exposure selects for resistance, and resistance, once established, is slow or effectively irreversible — depleting the effective-drug reserve in a way that persists in the population after the drug is withdrawn.
- In physiology and medicine, oxygen and many nutrients are beneficial up to a dose and toxic beyond it, and antibiotic overuse is a textbook case: antibiotics are beneficial against infection, but overuse past the point where the susceptible population is cleared selects for resistance (the self-amplifying inversion), depleting the effective-drug reserve — the secondary resource — and the resistant regime is hysteretic, persisting in the bacterial population long after the antibiotic is withdrawn.
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