Simulation of bacterial resistance for different antibiotic consumption strategies based on the Escherichia coli resistance to cephalosporins

Clinical Microbiology and Antimicrobial Chemotherapy. 2017; 19(4):321-326

Type
Journal article

Objective.

Objectives. To research the qualitative relationships between the level of antimicrobial resistance and the level of consumption of different antimicrobial agents, and to further apply this knowledge to minimize the level of resistance.

Materials and Methods.

An extensive simulation was performed based on the previously implemented model describing the relationship between a resistance and levels of antibiotic consumption. It makes possible to estimate the resistance growth rates in different antibiotic consumption strategies.

Results.

The study found that the increased consumption of fluoroquinolones significantly influence the increase in Escherichia coli resistance to cephalosporins, while the increase in the carbapenem consumption helps in containing the growth of E. coli resistance to cephalosporins. A forecast of the change in E. coli resistance to cephalosporins was calculated for different antibiotic consumption strategies.

Conclusions.

The best strategy leading to a decrease in E. coli resistance to cephalosporins is the strategy when the main consumed antibiotics are carbapenems, nitroimidazoles and cephalosporin/beta-lactamase inhibitor combinations and the fluoroquinolone consumption in the patient population is minimized.

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