ArticleProceedings of the National Academy of Sciences of the United States of America2018
Estimating the proportion of bystander selection for antibiotic resistance among potentially pathogenic bacterial flora.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 111 papers, 3 of them syntheses that pooled it.
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Who cites it
111 citing papers in PubMed, 3 syntheses or guidelines pooled it, 202 citations in OpenAlex.
- 45 years of tetracycline post exposure prophylaxis for STIs and the risk of tetracycline resistance: a systematic review and meta-analysis.BMC infectious diseases · 2024Pooled it
- Implications of reducing antibiotic treatment duration for antimicrobial resistance in hospital settings: A modelling study and meta-analysis.PLoS medicine · 2023Pooled it
- Drug-resistant enteric fever worldwide, 1990 to 2018: a systematic review and meta-analysis.BMC medicine · 2020Pooled it
- Quantifying antibiotic susceptibility and inoculum effects using transient dynamics of Pseudomonas aeruginosa.PLoS computational biology · 2026Article
- Artificial Intelligence-Guided Phenotypic Drug Repurposing Against Streptococcus pneumoniae.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Ethics of Antibiotic Course Duration: Shorter is Better.The American journal of bioethics : AJOB · 2026Article
- Modelling the role of the microbiome in antimicrobial resistance across scales.Nature microbiology · 2026Review
- Evidence-Based Assessment of the Role of Pharyngeal Gonorrhea and Commensal Neisseria Species in the Emergence of Antimicrobial Resistance in Neisseria Gonorrhoeae: Data Gaps and Future Research.The Journal of infectious diseases · 2026Review
- Physicians' perspectives on the perceived increase in respiratory infections post-COVID-19 in Pakistan: a qualitative study.BMC infectious diseases · 2026Article
- [Use of vaccines to prevent the development of bacterial resistance].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026Review
- Current Knowledge on Insecticide Resistance inInsects · 2026Review
- Quantifying the real-world impact of antibiotic use and genetic determinants of resistance on gonococcal dynamics.Nature microbiology · 2026Article
- Acute Respiratory Infections Due to Antibiotic-nonsusceptibleOpen forum infectious diseases · 2026Article
- Institutional spillover effects of antimicrobial use on antimicrobial resistance andAntimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Quantifying the bystander effect of antimicrobial use on the gut microbiome and resistome in Malawian adults.Nature communications · 2025Article
- Evaluation of Peptide-Based Vaccines AgainstVaccines · 2025Article
- Switching From Dual to Monotherapy for Gonorrhea is Associated With a Halving of Gonococcal Resistance to Azithromycin-A Modelling Study of MSM in Belgium.Open forum infectious diseases · 2025Article
- Variability of antimicrobial susceptibility of commensal Neisseria species supports its use as a marker of excessive antimicrobial consumption - reflections from the results of a four-country study.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2025Article
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
Bystander selection-the selective pressure for resistance exerted by antibiotics on microbes that are not the target pathogen of treatment-is critical to understanding the total impact of broad-spectrum antibiotic use on pathogenic bacterial species that are often carried asymptomatically. However, to our knowledge, this effect has never been quantified. We quantify bystander selection for resistance for a range of clinically relevant antibiotic-species pairs as the proportion of all antibiotic exposures received by a species for conditions in which that species was not the causative pathogen ("proportion of bystander exposures"). Data sources include the 2010-2011 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, the Human Microbiome Project, and additional carriage and etiological data from existing literature. For outpatient prescribing in the United States, we find that this proportion over all included antibiotic classes is over 80% for eight of nine organisms of interest. Low proportions of bystander exposure are often associated with infrequent bacterial carriage or concentrated prescribing of a particular antibiotic for conditions caused by the species of interest. Applying our results, we roughly estimate that pneumococcal conjugate vaccination programs result in nearly the same proportional reduction in total antibiotic exposures of
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