A stochastic model of susceptibility to antibiotic therapy—The effects of cross-resistance and treatment history

Summary 

Objective

Selection of antibiotic therapy is a complicated process, depending on, among others, the effect of cross-resistance between antibiotics. We propose a model, which incorporates information about treatment history in the form of information on the success or failure of the current treatment and which combines this with data on cross-resistance to predict the susceptibility to future antibiotic treatments, thus providing a systematic basis for revision of antibiotic treatment.

Methods and material

The stochastic model was built as a causal probabilistic network (CPN). Data used in the model were based on a bacteriology database including data on patient and episode unique pathogens cultured from a microbiological sample.

Results

In this paper, we develop a CPN that can exploit knowledge about cross-resistance between two consecutive treatments, explore the properties of this CPN and consider how the CPN can be integrated into a complete decision support system for selection of antibiotic therapy.

Conclusion

The model presented may be useful both as a theoretical tool describing cross-resistance between antibiotics and as a part of complete decision support system for selection of antibiotic therapy.

Keywords: Causal probabilistic networks, Bacterial infections, Antibiotic therapy, Cross-resistance