A theoretical examination of the relative importance of evolution management and drug development for managing resistance.
Drug resistance is a serious public health problem that threatens to thwart our ability to treat many infectious diseases. Repeatedly, the introduction of new drugs has been followed by the evolution of resistance. In principle, there are two complementary ways to address this problem: (i) enhancing drug development and (ii) slowing the evolution of drug resistance through evolutionary management. Although these two strategies are not mutually exclusive, it is nevertheless worthwhile considering whether one might be inherently more effective than the other. We present a simple mathematical model that explores how interventions aimed at these two approaches affect the availability of effective drugs. Our results identify an interesting feature of evolution management that, all else equal, tends to make it more effective than enhancing drug development. Thus, although enhancing drug development will necessarily be a central part of addressing the problem of resistance, our results lend support to the idea that evolution management is probably a very significant component of the solution as well.
Department of Biology, Queen's University, Kingston, Ontario, Canada K7L 3N6 nathan.mcclure@queensu.ca.
Nathan S
NS
McClure
Department of Biology, Queen's University, Kingston, Ontario, Canada K7L 3N6 Department of Mathematics and Statistics, Queen's University, Kingston, Ontario, Canada K7L 3N6.
Troy
T
Day
D000900:Anti-Bacterial Agents; D000962:Antimalarials; D005075:Biological Evolution; D055808:Drug Discovery; D004351:Drug Resistance; D008962:Models, Theoretical
D000900:Anti-Bacterial Agents; D000962:Antimalarials
chemotherapy; drug resistance; pharmaceuticals; treatment strategies