Predicting the future Streptococcus pneumoniae resistance landscape

Streptococcus pneumoniae resistance to antibiotics is considered a public health problem, and yet the link between year-to-year increases in resistance and antimicrobial consumption has been difficult to prove. Mathematical models and epidemiological studies have shown that there is no linear relationship between consumption and resistance, and that increasing resistance is caused by the removal of susceptible strains from the population. Pneumococcal conjugate vaccine has also been shown to have an impact over resistance. A model that relates resistance with the cumulative consumption of antibiotics over time explains low resistance rates in countries such as Germany and plateaus in resistance in the US. Moreover, understanding this temporal relationship allows us to predict that if the cumulative consumption stabilizes so will the resistance rates.