title: Management of drug resistance in the population: influenza as a case study.
abstract: The rise of drug resistance remains a major impediment to the treatment of some diseases caused by fast-evolving pathogens that undergo genetic mutations. Models describing the within-host infectious dynamics suggest that the resistance is unlikely to emerge if the pathogen-specific immune responses are maintained above a certain threshold during therapy. However, emergence of resistance in the population involves both within-host and between-host infection mechanisms. Here, we employ a mathematical model to identify an effective treatment strategy for the management of drug resistance in the population. We show that, in the absence of pre-existing immunity, the population-wide spread of drug-resistant pathogen strains can be averted if a sizable portion of susceptible hosts is depleted before drugs are used on a large scale. The findings, based on simulations for influenza infection as a case study, suggest that the initial prevalence of the drug-sensitive strain under low pressure of drugs, followed by a timely implementation of intensive treatment, can minimize the total number of infections while preventing outbreaks of drug-resistant infections.
authors.affiliation: Department of Mathematics and Statistics, The University of Winnipeg, Winnipeg, Manitoba, Canada. seyed.moghadas@nrc-cnrc.gc.ca
authors.forename: Seyed M
authors.initials: SM
authors.lastname: Moghadas
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D003140:Communicable Disease Control / Q000379:methods; D003198:Computer Simulation; D006801:Humans; D007251:Influenza, Human / Q000188:drug therapy* / Q000453:epidemiology; D008954:Models, Biological; D009975:Orthomyxoviridae / Q000187:drug effects*
chemical_list: D000998:Antiviral Agents