Evidence map›Paper›PMID 27338861›Full record

ArticleBMC microbiology2016

Multistrain models predict sequential multidrug treatment strategies to result in less antimicrobial resistance than combination treatment.

Amais Ahmad, Camilla Zachariasen, Lasse Engbo Christiansen, Kaare Græsbøll, Nils Toft, Louise Matthews, John Elmerdahl Olsen, Søren Saxmose Nielsen

Open access · goldAbstract read
In one paragraph

Article in BMC microbiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.2field-weighted citation impact, top 18% 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

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. Review
  3. Review
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

8 authors at 3 institutions in 2 countries.

Amais AhmadDepartment of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Grønnegårdsvej 8, DK-1870, Frederiksberg C, Denmark. amaisahmad@gmail.com.ORCID 0000-0002-8615-3117
Camilla ZachariasenDepartment of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
Lasse Engbo ChristiansenDepartment of Applied Mathematics and Computer Science, Technical University of Denmark, Richard Petersens Plads, 2800, Lyngby, Denmark.
Kaare GræsbøllDepartment of Applied Mathematics and Computer Science, Technical University of Denmark, Richard Petersens Plads, 2800, Lyngby, Denmark.
Nils ToftNational Veterinary Institute, Section of Epidemiology, Technical University of Denmark, Bulowsvej 27, DK-1870, Frederiksberg C, Denmark.
Louise MatthewsBoyd Orr Centre for Population and Ecosystem Health, Institute for Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
John Elmerdahl OlsenDepartment of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
Søren Saxmose NielsenDepartment of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Grønnegårdsvej 8, DK-1870, Frederiksberg C, Denmark.
University of Copenhagen · DKTechnical University of Denmark · DKGlasgow Centre for Population Health · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCombination treatment is increasingly used to fight infections caused by bacteria resistant to two or more antimicrobials. While multiple studies have evaluated treatment strategies to minimize the emergence of resistant strains for single antimicrobial treatment, fewer studies have considered combination treatments. The current study modeled bacterial growth in the intestine of pigs after intramuscular combination treatment (i.e. using two antibiotics simultaneously) and sequential treatments (i.e. alternating between two antibiotics) in order to identify the factors that favor the sensitive fraction of the commensal flora. Growth parameters for competing bacterial strains were estimated from the combined in vitro pharmacodynamic effect of two antimicrobials using the relationship between concentration and net bacterial growth rate. Predictions of in vivo bacterial growth were generated by a mathematical model of the competitive growth of multiple strains of Escherichia coli.

resultsSimulation studies showed that sequential use of tetracycline and ampicillin reduced the level of double resistance, when compared to the combination treatment. The effect of the cycling frequency (how frequently antibiotics are alternated in a sequential treatment) of the two drugs was dependent upon the order in which the two drugs were used.

conclusionSequential treatment was more effective in preventing the growth of resistant strains when compared to the combination treatment. The cycling frequency did not play a role in suppressing the growth of resistant strains, but the specific order of the two antimicrobials did. Predictions made from the study could be used to redesign multidrug treatment strategies not only for intramuscular treatment in pigs, but also for other dosing routes.

Indexed as

AmpicillinAnimalsAnti-Bacterial AgentsBacteriaBacterial LoadDisease Models, AnimalDrug Resistance, Multiple, BacterialDrug Therapy, CombinationEscherichia coliEscherichia coli InfectionsInjections, IntramuscularIntestinesMicrobial Sensitivity TestsSwineTetracyclineAmpicillinAnti-Bacterial AgentsTetracyclineAmpicillinAntimicrobial resistanceBacterial growthDosing strategiesPharmacodynamicPigTetracycline

Identifiers

PMID27338861
PMCPMC4917987
OpenAlexW2473469715

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.