Fuqua School of Business and Economics Department, Duke University, Durham, North Carolina.
Ann N Y Acad Sci. 2017 Jan;1388(1):5-17. doi: 10.1111/nyas.13300.
Widespread adoption of point-of-care resistance diagnostics (POCRD) reduces ineffective antibiotic use but could increase overall antibiotic use. Indeed, in the context of a standard susceptible-infected epidemiological model with a single antibiotic, POCRD accelerates the rise of resistance in the disease-causing bacterial population. When multiple antibiotics are available, however, POCRD may slow the rise of resistance even as more patients receive antibiotic treatment, belying the conventional wisdom that antibiotics are "exhaustible resources" whose increased use necessarily promotes the rise of resistance.
广泛采用即时耐药诊断(POCRD)可以减少无效的抗生素使用,但可能会增加总体抗生素使用量。事实上,在具有单一抗生素的标准易感-感染流行病学模型的背景下,POCRD 会加速致病细菌种群的耐药性上升。然而,当有多种抗生素可供使用时,POCRD 可能会减缓耐药性的上升,即使有更多的患者接受抗生素治疗,这与抗生素是“不可再生资源”的传统观念相悖,因为抗生素使用的增加必然会促进耐药性的上升。