التفاصيل البيبلوغرافية
| العنوان: |
Hedging against antiviral resistance during the next influenza pandemic using small stockpiles of an alternative chemotherapy |
| المؤلفون: |
Joseph T. Wu, Gabriel M. Leung, Marc Lipsitch, Ben S. Cooper, Steven Riley |
| المساهمون: |
The Pennsylvania State University CiteSeerX Archives |
| المصدر: |
http://www.sfmu.org/documents/File/grippeporcine/plme-06-05-wu-final.pdfTest. |
| بيانات النشر: |
Springer |
| سنة النشر: |
2009 |
| المجموعة: |
CiteSeerX |
| الوصف: |
Background: The effectiveness of single-drug antiviral interventions to reduce morbidity and mortality during the next influenza pandemic will be substantially weakened if transmissible strains emerge which are resistant to the stockpiled antiviral drugs. We developed a mathematical model to test the hypothesis that a small stockpile of a secondary antiviral drug could be used to mitigate the adverse consequences of the emergence of resistant strains. Methods and Findings: We used a multistrain stochastic transmission model of influenza to show that the spread of antiviral resistance can be significantly reduced by deploying a small stockpile (1 % population coverage) of a secondary drug during the early phase of local epidemics. We considered two strategies for the use of the secondary stockpile: early combination chemotherapy (ECC; individuals are treated with both drugs in combination while both are available); and sequential multidrug chemotherapy (SMC; individuals are treated only with the secondary drug until it is exhausted, then treated with the primary drug). We investigated all potentially important regions of unknown parameter space and found that both ECC and SMC reduced the cumulative attack rate (AR) and the resistant attack rate (RAR) unless the probability of emergence of resistance to the primary drug pA was so low (less than 1 in 10,000) that resistance was unlikely to be a problem or so high (more than 1 in 20) that resistance emerged as soon as primary drug monotherapy began. For example, when the basic reproductive number was 1.8 and 40 % of symptomatic individuals were treated with antivirals, AR and RAR |
| نوع الوثيقة: |
text |
| وصف الملف: |
application/pdf |
| اللغة: |
English |
| العلاقة: |
http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.513.1007Test; http://www.sfmu.org/documents/File/grippeporcine/plme-06-05-wu-final.pdfTest |
| الإتاحة: |
http://www.sfmu.org/documents/File/grippeporcine/plme-06-05-wu-final.pdfTest |
| حقوق: |
Metadata may be used without restrictions as long as the oai identifier remains attached to it. |
| رقم الانضمام: |
edsbas.E19F6D5E |
| قاعدة البيانات: |
BASE |
