Epidemiology and Infection

Antibiotics and antibiotic resistance: veterinary and human

Probabilistic network modelling of the impact of penicillin consumption on spread of pneumococci

D. KARLSSONa1a2 c1

a1 Infection Biology, School of Life Sciences, University of Skövde, Skövde, Sweden

a2 Department of Microbiology, Tumor, and Cell Biology, Karolinska Institutet, Stockholm, Sweden

SUMMARY

The worldwide increase of resistant S. pneumoniae is a growing clinical problem. In several countries, a more restrictive use of penicillin has been promoted in hope of slowing the rates of resistant pneumococci. However, the consequences of such an action on pneumococcal population dynamics are not fully understood. Thus, a network model was constructed to assess the impacts of penicillin consumption and between-strain competition on the spread of penicillin non-susceptible pneumococci. Model simulations suggest that the age distribution for carriage of penicillin non-susceptible pneumococci, in contrast to susceptible pneumococci, is affected by penicillin consumption. Furthermore, it appears extremely difficult to reduce the incidence of penicillin non-susceptible pneumococci by simply controlling penicillin consumption, assuming that reduced penicillin susceptibility does not confer a fitness cost for the organism. A more judicious use of penicillin together with control measures are in that case required to manage penicillin resistance in pneumococci.

(Accepted November 09 2010)

(Online publication December 15 2010)

Correspondence:

c1 Address for correspondence: Dr D. Karlsson, Infection Biology, School of Life Sciences, University of Skövde, Box 408, SE-541 28 Skövde, Sweden. (Email: diana.karlsson@his.se).

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