System Dynamics Model of Antibiotic Resistance

Emergence of antibiotic resistant diseases has reawakened dangers posed by microbes of the pre-antibiotic era. The diminishing efficacy of antibiotics and the decreased profitability of pharmaceutical antibiotic development has created an overuse of available drugs in medicine and in agriculture. As ‘lifestyle’ and chronic illness drugs become more popular, less investment is funneled to antibiotic Research and Development at the time when it is most needed for prevention of public health crises. "Superbugs" threaten to kill 10,000,000 people per year by 2050. In March of this year, the White House announced a $1.2 billion “National Action Plan for Combating Antibiotic-Resistant Bacteria”. In September, the G7 health ministers concluded that fighting antimicrobial resistant infections is a top priority. One of the most important aspects of this global initiative will be the proper presentation of the problem in addition to designing effective solutions.

Using a systems dynamic approach, we have a created a model of the rise in multi-drug resistant bacteria in the United States that can be used for multiple strains of bacteria such as P. aeruginosa, K. pneumoniae, S. pneumoniae, S. aureus, and E. coli. Our model is based on an alternative version available in the literature that simulates the dynamics of bacteria densities based on data up to the year 2000.

We plan to use the simulation model to evaluate potential policy options and drive a concerted public policy initiative including 1) the need for reduction of antibiotic use in favor of alternative preventive measures and alternative treatment options such as phage-based and lysin therapies 2) increased pharmaceutical research and development of novel antibiotics 3) university research of bacterial pathogenesis and resistance and 4) increased healthcare

professional education in individualized diagnostics and reporting of specific bacterial infections as well as the efficacious and prudent use of existing and novel antibiotics.