Evidence map›Paper›PMID 25253451›Full record

ArticleProceedings. Biological sciences2014

The path of least resistance: aggressive or moderate treatment?

Roger D Kouyos, C Jessica E Metcalf, Ruthie Birger, Eili Y Klein, Pia Abel zur Wiesch, Peter Ankomah, Nimalan Arinaminpathy, Tiffany L Bogich, Sebastian Bonhoeffer, Charles Brower and 13 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Proceedings. Biological sciences, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 1 pooled it
8.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 1 synthesis or guideline pooled it, 97 citations in OpenAlex.

  1. Interventions for the prevention of recurrent erysipelas and cellulitis.The Cochrane database of systematic reviews · 2017
    Pooled it
  2. Trial
  3. Trial
  4. Article
  5. The speed of vaccination rollout and the risk of pathogen adaptation.Journal of the Royal Society, Interface · 2025
    Article
  6. Article
  7. Developmental synchrony and extraordinary multiplication rates in pathogenic organisms.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2025
    Article
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  9. Review
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  12. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors at 15 institutions in 5 countries.

Roger D KouyosDepartment of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zürich, University of Zürich, Zürich, Switzerland.
C Jessica E MetcalfDepartment of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA Department of Zoology, Oxford University, Oxford, UK.
Ruthie BirgerDepartment of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA rbirger@princeton.edu.ORCID http://orcid.org/0000-0002-2960-5084
Eili Y KleinDepartment of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA Center for Advanced Modeling, Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA.
Pia Abel zur WieschDivision of Global Health Equity, Brigham and Women's Hospital and Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
Peter AnkomahDepartment of Biology, Emory University, Atlanta, GA, USA.
Nimalan ArinaminpathyDepartment of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA Department of Infectious Disease Epidemiology, Imperial College London, London, UK.
Tiffany L BogichDepartment of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
Sebastian BonhoefferInstitute of Integrative Biology ETH Zurich, Zurich, Switzerland.
Charles BrowerDepartment of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA Center for Disease Dynamics, Economics & Policy, Washington, DC, USA.
Geoffrey Chi-JohnstonDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Ted CohenDivision of Global Health Equity, Brigham and Women's Hospital and Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
Troy DayDepartments of Mathematics and Biology, Queen's University, Kingston, Ontario, Canada.
Bryan GreenhouseDepartment of Medicine, Division of Infectious Diseases, University of California, San Francisco, VA, USA.
Silvie HuijbenBarcelona Centre for International Health Research, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
Joshua MetlayGeneral Medicine Division, Massachusetts General Hospital, Boston, MA, USA.
Nicole MideoDepartment of Ecology and Evolutionary Biology, University of Toronto, Toronto, Ontario, Canada.
Laura C PollittCentre for Infectious Disease Dynamics, The Pennsylvania State University, University Park, State College, PA, USA Departments of Biology and Entomology, The Pennsylvania State University, University Park, State College, PA, USA Centre for Immunology, Infection and Evolution, University of Edinburgh, Edinburgh, UK.
Andrew F ReadCentre for Infectious Disease Dynamics, The Pennsylvania State University, University Park, State College, PA, USA Departments of Biology and Entomology, The Pennsylvania State University, University Park, State College, PA, USA Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
David L SmithDepartment of Zoology, Oxford University, Oxford, UK.
Claire StandleyDepartment of Health Policy, George Washington University, Washington, DC, USA.
Nina WaleCentre for Infectious Disease Dynamics, The Pennsylvania State University, University Park, State College, PA, USA Departments of Biology and Entomology, The Pennsylvania State University, University Park, State College, PA, USA.
Bryan GrenfellDepartment of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
Princeton University · USNational Institutes of Health · USBrigham and Women's Hospital · USJohns Hopkins University · USPennsylvania State University · USCenter for Disease Dynamics, Economics & Policy · USEmory University · USETH Zurich · CHGeorge Washington University · USHarvard University Press · USQueen's University · CAUniversitat de Barcelona · ESUniversity of California, San Francisco · USUniversity of Oxford · GBUniversity of Toronto · CA

Funding

Scientific and Technical Computing CoreP2CHD047879 · NICHD · PRINCETON UNIVERSITY · PI SALGANIK, MATTHEW J. · 2014 to 2018
$2.0M
Medical Research Council MR/K010174/1NICHD NIH HHS P2C HD047879
6 · The paper itself

Abstract

The evolution of resistance to antimicrobial chemotherapy is a major and growing cause of human mortality and morbidity. Comparatively little attention has been paid to how different patient treatment strategies shape the evolution of resistance. In particular, it is not clear whether treating individual patients aggressively with high drug dosages and long treatment durations, or moderately with low dosages and short durations can better prevent the evolution and spread of drug resistance. Here, we summarize the very limited available empirical evidence across different pathogens and provide a conceptual framework describing the information required to effectively manage drug pressure to minimize resistance evolution.

Indexed as

Biological EvolutionAnti-Infective AgentsDrug Resistance, MicrobialHumansInfectionsMicrobiotaAnti-Infective Agentsdrug resistanceevolutiontreatment strategies

Identifiers

PMID25253451
PMCPMC4211439
OpenAlexW2075429778

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.