Why is preventing antibiotic resistance so hard? Analysis of failed resistance management
| Autor: | Robert J. Woods, Shiwei Zhou, Camilo Barbosa |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty antibiotic resistance medicine.drug_class Health Toxicology and Mutagenesis 030106 microbiology Population Antibiotics antibiotic stewardship Medicine (miscellaneous) clinical decision making 03 medical and health sciences Antibiotic resistance Clinical decision making medicine AcademicSubjects/MED00860 Intensive care medicine education Ecology Evolution Behavior and Systematics Organism education.field_of_study Case Study Resistance (ecology) business.industry AcademicSubjects/SCI01130 030104 developmental biology translational evolutionary medicine Clinical case Risk assessment business |
| Zdroj: | Evolution, Medicine, and Public Health |
| ISSN: | 2050-6201 |
| DOI: | 10.1093/emph/eoaa020 |
| Popis: | We describe the case of a patient with pancreatitis followed by intra-abdominal infection in which source control was not achieved. Antimicrobial therapy led to the emergence of resistance in multiple organisms through multiple population dynamics processes. While the initial insult was not due to infection, subsequent infections with resistant organisms contributed to a poor outcome for the patient. Though resistance evolution was a known risk, it was difficult to predict the next organism that would arise in the setting of antibiotic pressure and its resistance profile. This case illustrates the clinical challenge of antibiotic resistance that current approaches cannot readily prevent. LAY SUMMARY Why is antibiotic resistance management so complex? Distinct evolutionary processes unfold when antibiotic treatment is initiated that lead, separately and together, to the undesired outcome of antibiotic resistance. This clinical case exemplifies some of those processes and highlights the dire need for evolutionary risk assessments to be incorporated into clinical decision making. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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