The DOI matches its Crossref record; 42 of the 42 references it cites were found in a registry or an index.
Implications of reducing antibiotic treatment duration for antimicrobial resistance in hospital settings: A modelling study and meta-analysis
Open accessAbstract
Background: Reducing antibiotic treatment duration is a key component of hospital antibiotic stewardship interventions. However, its effectiveness in reducing antimicrobial resistance is uncertain and a clear theoretical rationale for the approach is lacking. In this study, we sought to gain a mechanistic understanding of the relation between antibiotic treatment duration and the prevalence of colonisation with antibiotic-resistant bacteria in hospitalised patients. Methods and findings: We constructed 3 stochastic mechanistic models that considered both between- and within-host dynamics of susceptible and resistant gram-negative bacteria, to identify circumstances under which shortening antibiotic duration would lead to reduced resistance carriage. In addition, we performed a meta-analysis of antibiotic treatment duration trials, which monitored resistant gram-negative bacteria carriage as an outcome. We searched MEDLINE and EMBASE for randomised controlled trials published from 1 January 2000 to 4 October 2022, which allocated participants to varying durations of systemic antibiotic treatments. Quality assessment was performed using the Cochrane risk-of-bias tool for randomised trials. The meta-analysis was performed using logistic regression. Duration of antibiotic treatment and time from administration of antibiotics to surveillance culture were included as independent variables. Both the mathematical modelling and meta-analysis suggested modest reductions in resistance carriage could be achieved by reducing antibiotic treatment duration. The models showed that shortening duration is most effective at reducing resistance carriage in high compared to low transmission settings. For treated individuals, shortening duration is most effective when resistant bacteria grow rapidly under antibiotic selection pressure and decline rapidly when stopping treatment. Importantly, under circumstances whereby administered antibiotics can suppress colonising bacteria, shortening antibiotic treatment may increase the carriage of a particular resistance phenotype. We identified 206 randomised trials, which investigated antibiotic duration. Of these, 5 reported resistant gram-negative bacteria carriage as an outcome and were included in the meta-analysis. The meta-analysis determined that a single additional antibiotic treatment day is associated with a 7% absolute increase in risk of resistance carriage (80% credible interval 3% to 11%). Interpretation of these estimates is limited by the low number of antibiotic duration trials that monitored carriage of resistant gram-negative bacteria, as an outcome, contributing to a large credible interval. Conclusions: In this study, we found both theoretical and empirical evidence that reducing antibiotic treatment duration can reduce resistance carriage, though the mechanistic models also highlighted circumstances under which reducing treatment duration can, perversely, increase resistance. Future antibiotic duration trials should monitor antibiotic-resistant bacteria colonisation as an outcome to better inform antibiotic stewardship policies.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Median time to pathogen identification with standard techniques is approximately 96 h.
“Median times to pathogen identification with standard techniques have been reported near 96 h, a critical window during which unnecessary antimicrobial exposure can increase adverse events and the risk of colonization by resistant organisms (3–5).”
From Optimized use of the FilmArray Meningitis/Encephalitis panel for early discontinuation of antibiotic therapy (2026) · cites this paper as [5]
The Results section discusses antibiotic duration and resistant-bacteria carriage, but does not report a time to pathogen identification. Searches for “96 h” and conventional microbiology turnaround time found no supporting passage in our copy; page numbers were unavailable. (LLM, conf=0.73)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Barlam, T. F., Cosgrove, S. E., Abbo, L. M., MacDougall, C., Schuetz, A. N., Septimus, E. J., Srinivasan, A., Dellit, T. H., Falck-Ytter, Y. T., Fishman, N. O., et al. (2016) · Clinical Infectious Diseases · doi:10.1093/cid/ciw118 · Cited by 3,214 · cited 1×
“Reducing treatment duration is a common strategy used to reduce antibiotic consumption and a core feature of antibiotic stewardship programmes (ASPs) [1,2].”
BackgroundWatanabeSumio (2010) · arXiv (Cornell University) · doi:10.48550/arxiv.1004.2316 · Cited by 2,264 · cited 1×
“Model comparison was done using the Widely Applicable Information Criterion (WAIC), where lower values indicate improved model fit [30].”
MethodChastre, J., Wolff, M., Fagon, J.-Y., Chevret, S., Thomas, F., Wermert, D., Clementi, E., Gonzalez, J., Jusserand, D., Asfar, P., et al. (2003) · JAMA · doi:10.1001/jama.290.19.2588 · Cited by 1,376
Effect of antimicrobial agents on the ecological balance of human microflora
Sullivan, Å., Edlund, C., & Nord, C. E. (2001) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(01)00066-4 · Cited by 816 · cited 1×
“More recently, it has been recognised that, for most bacterial pathogens, antibiotic selection pressure largely results from “bystander” selection, which occurs when colonising bacteria are exposed to antibiotics that are not intentionally targeting them [13].”
BackgroundSchuts, E. C., Hulscher, M., Mouton, J. W., Verduin, C. M., Stuart, J. W. T. C., Overdiek, H. W. P. M., van der Linden, P. D., Natsch, S., Hertogh, C. M. P. M., Wolfs, T. F. W., et al. (2016) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(16)00065-7 · Cited by 772
The intestinal microbiota: Antibiotics, colonization resistance, and enteric pathogens
Kim, S., Covington, A., & Pamer, E. G. (2017) · Immunological Reviews · doi:10.1111/imr.12563 · Cited by 741 · cited 1×
“” The models assumed that antibiotics act within-host by selectively promoting the growth of existing resistant bacteria in the gut [17,18], and between-host by predisposing the treated individual to become more likely to transmit resistant bacteria as a consequence of a higher bacterial load (Fig 1) [19].”
BackgroundDrug Resistance Mechanisms in Mycobacterium tuberculosis
Palomino, J. C., & Martin, A. (2014) · Antibiotics · doi:10.3390/antibiotics3030317 · Cited by 467 · cited 1×
“Fourthly, our models did not account for de novo mutations during treatment, which are an important source of resistance for certain organisms such as Mycobacterium tuberculosis [46].”
Gupta, R. K., Gregson, J., Parkin, N. T., Haile-Selassie, H., Tanuri, A., Forero, L., Kaleebu, P., Watera, C., Aghokeng, A. F., Mutenda, N., et al. (2017) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(17)30702-8 · Cited by 416 · cited 1×
“Examples of pathogens that may become resistant during treatment include Mycobacterium tuberculosis, fluoroquinolone-resistant Enterobacterales, and human immunodeficiency virus, especially with inappropriate dosing and duration [11,12].”
BackgroundAntibiotic resistance in Enterobacteriaceae: mechanisms and clinical implications
Iredell, J. R., Brown, J. C., & Tagg, K. A. (2016) · BMJ · doi:10.1136/bmj.h6420 · Cited by 414
Duration of Antibiotic Treatment in Community-Acquired Pneumonia
Uranga, A., España, P. P., Bilbao, A., Quintana, J. M., Arriaga, I., Intxausti, M., Lobo, J. L., Tomás, L., Camino, J., Nuñez, J. M., et al. (2016) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2016.3633 · Cited by 292
Effect of Short-Course, High-Dose Amoxicillin Therapy on Resistant Pneumococcal Carriage
Schrag, S. J., Peña, C., Fernández, J., Sánchez, J., Gómez, V., Pérez-Then, E. N., Feris, J. M., & Besser, R. E. (2001) · JAMA · doi:10.1001/jama.286.1.49 · Cited by 233
Totsika, M., Beatson, S. A., Sarkar, S., Phan, M., Petty, N. K., Bachmann, N. L., Szubert, M., Sidjabat, H. E., Paterson, D. L., Upton, M., et al. (2011) · PLoS ONE · doi:10.1371/journal.pone.0026578 · Cited by 218 · cited 1×
“Examples of pathogens that may become resistant during treatment include Mycobacterium tuberculosis, fluoroquinolone-resistant Enterobacterales, and human immunodeficiency virus, especially with inappropriate dosing and duration [11,12].”
BackgroundTedijanto, C., Olesen, S. W., Grad, Y. H., & Lipsitch, M. (2018) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1810840115 · Cited by 197 · cited 1×
“Since most resistance selection in common bacterial pathogens is due to “bystander” selection [45], trials that only look at resistance in bacteria that are causing infections being treated are potentially missing a big part of the picture.”
BackgroundReddy, P., Malczynski, M., Obias, A. A., Reiner, S., Jin, N., Huang, J., Noskin, G. A., & Zembower, T. (2007) · Clinical Infectious Diseases · doi:10.1086/521260 · Cited by 190
Sandberg, T., Skoog, G., Hermansson, A. B., Kahlmeter, G., Kuylenstierna, N., Lannergård, A., Otto, G., Settergren, B., & Ekman, G. S. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60608-4 · Cited by 187
Tacconelli, E., Angelis, G. D., Cataldo, M. A., Mantengoli, E., Spanu, T., Pan, A., Corti, G., Radice, A., Stolzuoli, L., Antinori, S., et al. (2009) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00431-09 · Cited by 156
Modeling antibiotic resistance in hospitals: The impact of minimizing treatment duration
D’Agata, E. M. C., Magal, P., Olivier, D., Ruan, S., & Webb, G. F. (2007) · Journal of Theoretical Biology · doi:10.1016/j.jtbi.2007.08.011 · Cited by 155 · cited 1×
“The first study by D’Agata and colleagues is a theoretical agent-based model, which concluded that rapid initiation of treatment and minimising duration were likely to reduce antimicrobial resistance in a hospital epidemic setting [42].”
BackgroundDuration of antibiotic therapy: shorter is better
Spellberg, B., & Rice, L. B. (2019) · Annals of Internal Medicine · doi:10.7326/m19-1509 · Cited by 155 · cited 1×
“The primary motivation behind shortening treatment duration is the expectation that it will reduce antibiotic selective pressure for antimicrobial resistance in treated individuals and, over time, will lead to lower prevalence of resistance at a population level [7].”
BackgroundShortened Antimicrobial Treatment for Acute Otitis Media in Young Children
Hoberman, A., Paradise, J. L., Rockette, H. E., Kearney, D. H., Bhatnagar, S., Shope, T. R., Martin, J. M., Kurs‐Lasky, M., Copelli, S. J., Colborn, D. K., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1606043 · Cited by 147
Austin, D. J., Kakehashi, M., & Anderson, R. M. (1997) · Proceedings of the Royal Society B Biological Sciences · doi:10.1098/rspb.1997.0227 · Cited by 132 · cited 1×
“In the exclusive colonisation model, patients could be carriers of either susceptible or resistant bacteria but not of both at the same time [20].”
BackgroundThe Impact of Different Antibiotic Regimens on the Emergence of Antimicrobial-Resistant Bacteria
D’Agata, E. M. C., Dupont‐Rouzeyrol, M., Magal, P., Olivier, D., & Ruan, S. (2008) · PLoS ONE · doi:10.1371/journal.pone.0004036 · Cited by 123 · cited 1×
“The second study by D’Agata and colleagues focused on withinhost dynamics of resistance by effective and ineffective antibiotic killing [43].”
BackgroundChung, G. W.-T., Wu, J. E., Yeo, C. L., Chan, D., & Hsu, L. Y. (2013) · Virulence · doi:10.4161/viru.21626 · Cited by 112
Spartan: A Comprehensive Tool for Understanding Uncertainty in Simulations of Biological Systems
Alden, K., Read, M. N., Timmis, J., Andrews, P. S., Veiga‐Fernandes, H., & Coles, M. C. (2013) · PLoS Computational Biology · doi:10.1371/journal.pcbi.1002916 · Cited by 110 · cited 1×
“4 (2021-02-15) [25] using packages msm [26], pse [27], and spartan [28].”
MethodBouglé, A., Tuffet, S., Federici, L., Léone, M., Monsel, A., Dessalle, T., Amour, J., Dahyot‐Fizelier, C., Barbier, F., Luyt, C. E., et al. (2022) · Intensive Care Medicine · doi:10.1007/s00134-022-06690-5 · Cited by 99 · cited 1×
“One was excluded because the trial reported a mixture of antibiotics and multidrug-resistant bacteria carriage without specifying if the organisms were gram-positive or gram-negative [33].”
BackgroundDow, G., Rao, P., Harding, G. K. M., Brunka, J., Kennedy, J., Alfa, M. J., & Nicolle, L. E. (2004) · Clinical Infectious Diseases · doi:10.1086/423000 · Cited by 95
van Duijn, P. J., Verbrugghe, W., Jorens, P. G., Spöhr, F., Schedler, D., Deja, M., Rothbart, A., Annane, D., Lawrence, C., Van, J.-C. N., et al. (2018) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(18)30056-2 · Cited by 90
Within-host dynamics shape antibiotic resistance in commensal bacteria
Davies, N. G., Flasche, S., Jit, M., & Atkins, K. E. (2019) · Nature Ecology & Evolution · doi:10.1038/s41559-018-0786-x · Cited by 87 · cited 1×
“In the co-colonisation model, these abundances were dichotomised into highAU : PleasenotethatasperPLOSstyle; italicsshouldnotbeusedforemphasisofwords:Hence; highandlowinthesentenceIntheco colonisationmodel; theseabundancesweredichotomisedintohigh:::havebeenchangedtoregulartext: and low, and only b cteria carried at a…”
BackgroundTroché, G., Toly, L.-M., Guibert, M., & Zazzo, J. (2005) · Infection Control and Hospital Epidemiology · doi:10.1086/502521 · Cited by 84
Eradication Therapy against Pseudomonas aeruginosa in Non-Cystic Fibrosis Bronchiectasis
Orriols, R., Hernando, R., Marcellés, A. F., Terradas, S., & Ronsano, J. B. M. (2015) · Respiration · doi:10.1159/000438490 · Cited by 80
Dubinsky‐Pertzov, B., Temkin, E., Harbarth, S., Fankhauser-Rodriguez, C., Carević, B., Radovanovic, I., Ris, F., Kariv, Y., Buchs, N. C., Schiffer, E. R. C., et al. (2018) · Clinical Infectious Diseases · doi:10.1093/cid/ciy768 · Cited by 74
The evolution of antibiotic resistance in a structured host population
Blanquart, F., Lehtinen, S., Lipsitch, M., & Fraser, C. (2018) · Journal of The Royal Society Interface · doi:10.1098/rsif.2018.0040 · Cited by 63 · cited 1×
“The other study is by Blanquart and colleagues, in which antibiotic prescription and antimicrobial resistance data specific to Streptococcus pneumoniae from the Israeli community were used [44].”
Lutsar, I., Chazallon, C., Trafojer, U., de Cabre, V. M., Auriti, C., Bertaina, C., Carducci, F. I. C., Canpolat, F. E., Esposito, S., Fournier, I., et al. (2020) · PLoS ONE · doi:10.1371/journal.pone.0229380 · Cited by 55
Ceran, N., Mert, D., Kocdogan, F. Y., Erdem, İ., ÖZYÜREK, S., Göktaş, P., Adalati, R., & Ceran, N. (2010) · Journal of Infection and Chemotherapy · doi:10.1007/s10156-010-0079-z · Cited by 51
Niehus, R., van Kleef, E., Mo, Y., Turlej-Rogacka, A., Lammens, C., Carmeli, Y., Goossens, H., Tacconelli, E., Carević, B., Preoțescu, L., et al. (2020) · eLife · doi:10.7554/elife.49206 · Cited by 38 · cited 1×
“We also assumed a total carrying capacity for gramnegative bacteria [23] and note that newly admitted patients may carry fewer bacteria than the Fig 1.”
BackgroundSelf-citationModels to Study Colonisation and Colonisation Resistance
Boureau, H., Hartmann, L., Karjalainen, T. K., Rowland, I. R., & Wilkinson, M. H. F. (2000) · Microbial Ecology in Health and Disease · doi:10.1080/089106000750060503 · Cited by 32
Léo, S., Lazarević, V., von Dach, E., Kaiser, L., Prendki, V., Schrenzel, J., Huttner, B. D., & Huttner, A. C. (2021) · EBioMedicine · doi:10.1016/j.ebiom.2021.103566 · Cited by 32
Duration of Carbapenemase-Producing Enterobacteriaceae Carriage in Hospital Patients
Mo, Y., Hernández-Koutoucheva, A., Musicha, P., Bertrand, D., Lye, D. C., Ng, O. T., Fenlon, S. N., Chen, S. L., Ling, M. L., Tang, W., et al. (2020) · Emerging infectious diseases · doi:10.3201/eid2609.190592 · Cited by 29 · cited 4×
“When stopping antibiotics leads to rapid decline in the resistant strain’s abundance, shortening duration is more likely to result in a substantial reduction in the prevalence of resistance [18].”
BackgroundInfluentialSelf-citationMcCallum, G. B., Fong, S. M., Grimwood, K., Nathan, A. M., Byrnes, C. A., Ooi, M. H., Nachiappan, N., Saari, N., Morris, P. S., Yeo, T. W., et al. (2022) · The Pediatric Infectious Disease Journal · doi:10.1097/inf.0000000000003558 · Cited by 25
Barratt, S., Bielicki, J. A., Dunn, D. T., Faust, S. N., Finn, A. H. R., Harper, L. M., Jackson, P., Lyttle, M. D., Powell, C., Rogers, L., et al. (2021) · Health Technology Assessment · doi:10.3310/hta25600 · Cited by 14
Merode, T. V., Nys, S., Raets, I., & Stobberingh, E. E. (2005) · European Journal of General Practice · doi:10.3109/13814780509178238 · Cited by 11
Models to Study Colonisation and Colonisation Resistance
Boureau, L. H. H. (2000) · Microbial Ecology in Health and Disease · doi:10.1080/08910600050216246 · Cited by 7 · cited 1×
“In the within-host growth model, bacterial population sizes could vary continuously but had to be above a threshold in order to be capable of transmission to others [22].”
BackgroundLéo, S., Lazarević, V., von Dach, E., et al. (2021) · SSRN Electronic Journal · doi:10.2139/ssrn.3761111 · Cited by 5
Flagged first, then by citations
Research works printed but not linked: 1
- Higgins JP, Jelena S, Page MJ, Elbers RG, Sterne JA. Cochrane Handbook for Systematic Reviews of Interventions version 6.2 Chapter 8: Assessing risk of bias in a randomized trial. 2021 [cited 2021 May 6]. https://training.cochrane.org/handbook/current/chapter-08
Cited by
Sorted by citations
Antimicrobial Resistance: Addressing a Global Threat to Humanity
Walsh, T. R., Gales, A. C., Laxminarayan, R., & Dodd, P. C. (2023) · PLoS Medicine · doi:10.1371/journal.pmed.1004264 · Cited by 407
“The authors concluded that shortening antibiotic treatment duration may increase or decrease colonization by resistant bacteria, dependent upon individual and combined bacterial and antibiotic characteristics [14].”
BackgroundVaughn, V. M., Dickson, R. P., Horowitz, J. K., & Flanders, S. A. (2024) · JAMA · doi:10.1001/jama.2024.14796 · Cited by 226
Mo, Y., Booraphun, S., Li, A., Domthong, P., Kayastha, G. K., Lau, Y. H., Chetchotisakd, P., Limmathurotsakul, D., Tambyah, P. A., Cooper, B. S., et al. (2024) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(23)00418-6 · Cited by 70
Self-citationHoward, A., Reza, N., Green, P. L., Mo, Y., Duffy, E. M., Mwandumba, H. C., Gerada, A., & Hope, W. W. (2025) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(25)00313-5 · Cited by 31
Self-citationKuijpers, S. M. E., Buis, D. T. P., Ziesemer, K. A., van Hest, R. M., Schade, R. P., Sigaloff, K., & Prins, J. M. (2024) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(24)00456-0 · Cited by 24
Waldron, C.-A., Pallmann, P., Schoenbuchner, S. M., Harris, D., Brookes‐Howell, L., Mateus, C., Bernatoniene, J., Cathie, K., Faust, S. N., Hinds, L., et al. (2025) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(24)00306-7 · Cited by 19
“36 There was no statistically significant difference in the duration of hospitalisation, recurrence of infection or rehospitalisation, or 28-day mortality, but in-hospital mortality was significantly reduced in procalcitonin-guided therapy compared with usual care.”
Kumawat, J., Jain, S., Patel, S., Misra, N., Jain, P., Hashmi, S. Z., Dwivedi, J., & Kishore, D. (2024) · Journal of Molecular Structure · doi:10.1016/j.molstruc.2024.138668 · Cited by 12
Study on the persistence of ciprofloxacin and sulfamethoxazole in simulated drinking water systems
Rilstone, V., Filion, Y., & Champagne, P. (2025) · ENVIRONMENTAL SYSTEMS RESEARCH · doi:10.1186/s40068-025-00396-5 · Cited by 10
“When bacteria and biofilms are exposed to antibiotics for a prolonged duration, the probability of resistance promotion increases (Mo et al. 2023), further emphasizing the importance of examining their long-term behaviour in drinking water.”
Antimicrobial Stewardship Programs in Pediatric Intensive Care Units: A Systematic Scoping Review
Liberati, C., Brigadoi, G., Barbieri, E., Giaquinto, C., & Donà, D. (2025) · Antibiotics · doi:10.3390/antibiotics14020130 · Cited by 10
“A recent meta-analysis showed that reducing antimicrobial duration may increase or decrease colonization by MDROs, dependent upon individual and bacterial characteristics, emphasizing the importance of colonization monitoring to inform antimicrobial stewardship in PICUs [38].”
Stop antibiotics when you feel better? Opportunities, challenges and research directions
Borek, A., Ledda, A., Pouwels, K. B., Butler, C., Hayward, G., Walker, A. S., Robotham, J. V., & Tonkin-Crine, S. K. (2024) · JAC-Antimicrobial Resistance · doi:10.1093/jacamr/dlae147 · Cited by 8
Protecting healthcare and patient pathways from infection and antimicrobial resistance
Cocker, D., Fitzgerald, R. J., Brown, C. S., & Holmes, A. H. (2024) · BMJ · doi:10.1136/bmj-2023-077927 · Cited by 9
Moreira, M. V. B., de Freitas, L. R., Fonseca, L., Moreira, M. J. B., Balieiro, C. C. A., Marques, I. R., & Mari, P. C. (2024) · European Journal of Pediatrics · doi:10.1007/s00431-024-05512-8 · Cited by 7
Sethi, N. J., Carlsen, E. M., Tabassum, A., Cortes, D., Mark.øw, S., Schmidt, I. M., Christensen, M. M., Kirkedal, A. K., Kai, C. M., Bjerre, C. K., et al. (2025) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(25)00075-1 · Cited by 6
Antibiotic Treatment in Patients Hospitalized for Nonsevere COVID-19
Pulia, M. S., Griffin, M., Schwei, R. J., Pop-Vicas, A. E., Schulz, L. T., Shieh, M., Pekow, P. S., Vaughn, V. M., & Lindenauer, P. K. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.11499 · Cited by 6
Cai, Y., Booraphun, S., Li, A., Kayastha, G. K., Tambyah, P. A., Cooper, B. S., Graves, N., & Mo, Y. (2024) · The Lancet Global Health · doi:10.1016/s2214-109x(24)00327-9 · Cited by 6
Self-citationAntibacterial Potential of Symmetrical Twin-Drug 3,6-Diaminoxanthones
Resende, D. I. S. P., Durães, F., Zubarioglu, S., Freitas‐Silva, J., Szemerédi, N., Pinto, M. M. M., Pinto, E., da Costa, P. M., Spengler, G., & Sousa, E. (2024) · Pharmaceuticals · doi:10.3390/ph17020209 · Cited by 5
“Current medications are losing efficacy, and while infections persist in the Pharmaceuticals 2024 , 17 , 209 2 of 18 body, the risk of spreading to others increases and creates a progressively severe risk for global public health [3,4].”
BackgroundYoshii, Y., Thiriet-Rupert, S., Lebeaux, D., Ghigo, J., & Beloin, C. (2026) · npj Biofilms and Microbiomes · doi:10.1038/s41522-025-00906-4 · Cited by 4
“Although the link between treatment duration and resistance is debated 58 , treatment failure from short-term regimens, even if not leading to the emergence of antibiotic resistance, still requires retreatment and is therefore associated with a signi fi cant health and economic burden 59 .”
Vissing, N. H., Skajaa, T., Grosen, D. W., Albertsen, B. K., Als-Nielsen, B. E. T., Hasle, H., Koch, M. M., Rasmussen, A. H., Brok, J. S., Hjalgrim, L. L., et al. (2026) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(26)00039-8 · Cited by 4
Crowley, P. D., Siegel, L. R., & Dickinson, D. T. (2025) · Journal of Palliative Medicine · doi:10.1089/jpm.2025.0040 · Cited by 3
“27 If the patient wishes to have treatment of the suspected infectious symptom, the clinician should pursue a full course with an appropriate antibiotic (examples for common infections are in Fig.”
Howley, F., Jones, E., Anderson, C., Fagan, R., Grennan, S., Korn, B., Townsend, L., Bannan, C., & Conneely, A. (2025) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofaf670 · Cited by 3
“Prolonged empiric antimicrobial therapy has broader consequences for the development of antimicrobial resistance, with longer antimicrobial treat-ment courses associated with increased carriage of resistant organisms [25, 26].”
Chen, Z., Wu, J. T., Ye, X., Li, Z., JingWang, Tian, Y., Zhou, L., Ni, J., Jin, J., & Zhang, W. (2025) · Annals of Intensive Care · doi:10.1186/s13613-025-01605-1 · Cited by 3
“For instance, work by Mo et al. [42] indicated that while meta-analysis associated an additional day of antibiotic therapy with an approximate 7% absolute increase in the risk of resistant bacteria carriage, mathematical modeling further suggested this association is context-dependent.”
Risk factors for detection of Pseudomonas aeruginosa in clinical samples upon hospital admission
Reyle, R., Schwab, F., Saydan, S., Behnke, M., Leistner, R., Gastmeier, P., Geffers, C., & Kramer, T. S. (2025) · Antimicrobial Resistance and Infection Control · doi:10.1186/s13756-025-01527-4 · Cited by 3
“Improved and rational use of antimicrobial substances could lower resistance rates [6].”
Mo, Y., Booraphun, S., Li, A. T., Domthong, P., Kayastha, G. K., Lau, Y. H., Chetchotisakd, P., Limmathurotsakul, D., Tambyah, P. A., Cooper, B. S., et al. (2023) · SSRN Electronic Journal · doi:10.2139/ssrn.4492691 · Cited by 3
Self-citationTay, A. Y. W., Liow, M. H. L., Pang, H. N., Tay, D. K. J., Yeo, S. J., & Tan, A. H. C. (2025) · The Journal of Arthroplasty · doi:10.1016/j.arth.2025.10.017 · Cited by 2
Modelling the role of the microbiome in antimicrobial resistance across scales
Pagani, L., León‐Sampedro, R., Amicone, M., Tepekule, B., Witzany, C., Brugger, S. D., de Vos, M. G. J., Mitri, S., Bakkeren, E., Bottery, M. J., et al. (2026) · Nature Microbiology · doi:10.1038/s41564-026-02390-8 · Cited by 3
“Models have clarified why shorter antibiotic treatments can reduce resistance without compromising patient recovery 24–27 , as well as why plasmids persist in the absence of antibiotics through source-sink and compensatory dynamics 28,29 , but no single mechanism yet fully accounts for the observed…”
Simplified oral antibiotic regimen for pyogenic flexor tenosynovitis
Lataste, E., Jeudy, J., Cesari, B., & Bigorre, N. (2026) · Hand surgery & rehabilitation · doi:10.1016/j.hansur.2026.102724 · Cited by 2
Ntais, C., & Chatziprodromidou, I. P. (2026) · Infectious Disease Reports · doi:10.3390/idr18040070 · Cited by 2
“When patients discontinue their medication too early upon noticing an improvement in clinical symptoms or when they do not receive adequate doses, this creates an opportunity for partially resistant bacterial populations to develop into completely resistant populations [15,16].”
Loftus, R. W., Dexter, F., Parra, M. C., Hwang, S. M., Robinson, A. D. M., Charnin, J. E., Loftus, C. P., & Wanta, B. T. (2025) · Cureus · doi:10.7759/cureus.81885 · Cited by 2
“…with prior work showing that transmission of antibiotic-resistant isolates among anesthesia workspace reservoirs is associated with increased risk of infection development [2,22] and adding to prior work by the extension from surgical site infections to all-cause healthcare-associated infections.”
InfluentialLaPrete, C. R., Ahmed, S. M., Toth, D. J. A., Reimer, J. R., Vaughn, V. M., Adler, F. R., & Keegan, L. T. (2025) · Bulletin of Mathematical Biology · doi:10.1007/s11538-025-01432-2 · Cited by 2
“…et al. 2014); antibiotics have been shown to disrupt the gut microbiome, particularly in children where it can lead to conditions such as obesity (Liu et al. 2021); and may increase an individual’s risk of developing future antibiotic-resistant infections (Mo et al. 2023; Magill et al. 2014).”
Ong, D. T., Mertaniasih, N. M., Santoso, K. H., Atika, A., Koendhori, E. B., & Endraswari, P. D. (2025) · Journal of Pure and Applied Microbiology · doi:10.22207/jpam.19.2.26 · Cited by 2
Yang, Y.-T., Wong, D., Zhong, X., Fahmi, A., Ashcroft, D. M., Hand, K. S. P., Massey, J., MacKenna, B., Mehrkar, A., Bacon, S., et al. (2024) · Antibiotics · doi:10.3390/antibiotics13060566 · Cited by 2
“Furthermore, the gut microbiota serves as a reservoir for antibiotic resistance genes (ARGs), with prolonged treatment linked to increased antimicrobial resistance (AMR) risks [18,19].”
BackgroundNicolau-Guillaumet, N., Moutel, M., Plouzeau-Jayle, C., Pean de Ponfilly, G., Courbin, V., Ranc, A.-G., Revillet, H., Mourvillier, B., Hentzien, M., Muggeo, A., et al. (2026) · Microbiology Spectrum · doi:10.1128/spectrum.00566-26 · Cited by 1
Mugada, V., Galanki, V., Puvvada, S. M., Triveni, Y., Kumar, C. V. N., & Ravipati, A. (2024) · Hacettepe University Journal of the Faculty of Pharmacy · doi:10.52794/hujpharm.1490671 · Cited by 1
Short-course antibiotic strategies for ventilator-associated pneumonia
Tan, W. C., Quah, J., & Li, A. (2025) · Current Opinion in Infectious Diseases · doi:10.1097/qco.0000000000001094 · Cited by 1
“Apart from increased drug toxicities [10], prolonged antibiotic that MDR pathogens emerged more frequently among patients with pulmonary infection recurrence who had received 15 days of antibiotics as compared to 8 days [12].”
Global Antimicrobial Resistance: Strategies and Challenges
Laghari, S. A., Kalwar, Q., Rahimoon, M. M., Saboor, A., Soomro, F. U. R., Hussain, F., Muhammad, T., Soomro, M. A., & Soomro, A. U. R. (2025) · MARKHOR (The Journal of Zoology) · doi:10.54393/mjz.v6i1.146 · Cited by 1
Kuster, S., MS, C. P. G., O’Shea, T. M., Ghert, M. A., & Mertz, D. (2025) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiaf513 · Cited by 1
“…additional day of antibiotics increases the absolute risk for carriage of resistant gram-negative pathogens by 7%, in a meta-analysis from mixed study populations comparing short-versus long-term antibiotic treatment for urinary tract infections, otitis media, and neonatal late-onset sepsis [39].”
Ong, S. W. X., Patrikar, A., Pinto, R. L., Mahar, R. K., Rishu, A., Davis, J. S., Fowler, R. A., Tong, S. Y. C., & Daneman, N. (2026) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofag142 · Cited by 1
“…with at least 1 emergency department visit. c Note that we are unable to report numbers of individual AROs or CDI due to privacy restrictions from ICES precluding disallowing reporting of small cell sizes < 6 to limit re-identification risk. settings compared to low-transmission settings [18].”
Factors influencing antibiotic use in confirmed viral respiratory tract infections
Fauzi, S. M. M., Egwu, A., Kelleher, M., Kent, B. D., Nee, R., Conway, A., McGrath, J., Bergin, C. J., & Townsend, L. (2026) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkag321 · Cited by 1
Wrenn, R., Slaton, C. N., Diez, T., Turner, N., Yarrington, M. E., Anderson, D. J., & Moehring, R. W. (2024) · Infection Control and Hospital Epidemiology · doi:10.1017/ice.2024.16 · Cited by 1
Pérez, S. G., Díaz‐Brochero, C., Herazo, J. R. G., & Múñoz, Ó. (2024) · Therapeutic Advances in Infectious Disease · doi:10.1177/20499361241237615 · Cited by 1
Antimicrobial stewardship: from theory to reality in a resource-limited setting (and beyond)
Ochoa‐Hein, E., & Galindo‐Fraga, A. (2024) · Frontiers in Antibiotics · doi:10.3389/frabi.2024.1492319 · Cited by 1
Raina, R., Subhash, S., Schmitt, C. P., & Shroff, R. C. (2024) · Peritoneal Dialysis International · doi:10.1177/08968608241279094 · Cited by 1
“16 reported thatdecreasedantibiotictreatmentdur-ation was associated with a reduction in antibiotic resistance, and a retrospective cohort analysis of hospitalized adult patients by Brower et al. 17 further af fi rmed that most patients were treated with antibiotics beyond recommended guidelines.”
Ahmed, S. M., LaPrete, C. R., Ciglenečki, I., Azman, A. S., Leung, D. T., & Keegan, L. T. (2024) · medRxiv · doi:10.1101/2024.11.04.24316579 · Cited by 1
Sayyar, Z., Sadigh, M. K., Pakdel, P. M., Sadeghpour, P., & Sayyar, M. R. (2025) · Journal of Polymers and the Environment · doi:10.1007/s10924-025-03541-4
“The OFL is chemically stable in the environment [ 2 , 4 ].”
Are Procalcitonin Measures a Reliable Predictor of Stopping Antibiotics Among Patients With Sepsis?
Arrigo, M., & Huber, L. C. (2025) · JAMA · doi:10.1001/jama.2025.0788
A multicenter audit of 1295 daptomycin prescriptions in the Auvergne-Rhône-Alpes region
Cras, R. L., Solomovici, B., Lesprit, P., Foroni, L., Ameye, T., Baud, O., Boden, S., Bourget, S., Bricca, R., Chatron, C., et al. (2025) · Infectious Diseases Now · doi:10.1016/j.idnow.2025.105106
Cras, R. L., Vidal, P., Pavèse, P., François, P., Sette, A. L., & Lesprit, P. (2025) · Infectious Diseases Now · doi:10.1016/j.idnow.2025.105165
Prebble, K., & Marefat, L. (2025) · Hospital Pharmacy · doi:10.1177/00185787251390774
Ilges, D., Jensen, K. L., Draper, E. W., Thompson, E., Quillen, J. K., Hannan, K. N. A., Ton, A. N., Prigge, K. A., Vergidis, P. I., Virk, A., et al. (2026) · Clinical Infectious Diseases · doi:10.1093/cid/ciag244
Outcomes of Surgical Site Infection Following Cranial Surgery From a UK Tertiary Center
Jones, T. P., Davis, P., O’Sullivan, O., Ganau, M., Halliday, J., Hadjipavlou, G., Scarborough, M., & Andersson, M. I. (2026) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofag369
“Indications for earlier surgical interventions, as well as approaches that better delineate only those patients who would benefit from prolonged courses of therapy, would be helpful to reduce the risk of antimicrobial resistance and toxicity [25].”
Cai, Y., Morton, A., Graves, N., & Paterson, D. L. (2026) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2026.09.002
Смирнова, С. С., Kameneva, A., Avdyunin, D. D., Stagilskaya, Y. S., & Zhuikov, N. N. (2026) · Epidemiology and Infectious Diseases · doi:10.17816/eid705333
Metadata
- Authors
- Mo, Y., Oonsivilai, M., Lim, C., Niehus, R., & Cooper, B. S.
- Affiliations
- National University of Singapore (SG)
- Mahidol University (TH)
- Corresponding author
- Mo, Yin
- Venue
- PLOS Medicine
- Publisher
- Public Library of Science (PLoS)
- Published
- 2023-06-15
- Volume
- 20
- Issue
- 6
- Pages
- e1004013
- ISSN
- 1549-1277 (ISSN-L)
- 1549-1676
- PMC
- PMC10270346
- OpenAlex
- W4380870364
- Cited by
- 52
- References
- 40
- Citations by year
- 2026: 12 · 2025: 22 · 2024: 16 · 2023: 2
- FWCI
- 9.81
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Greater South Information System
- Funders
- National Medical Research Council (NMRC/Fellowship/0051/2017)
- Medical Research Council (MR/V028456/1)
- Wellcome Trust (206736/Z/17/Z, 106698/Z/14/Z)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
- Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Keywords
- antibiotic duration, antimicrobial resistance, hospital antibiotic stewardship, Gram-negative bacteria, bacterial colonization, mechanistic mathematical model, antibiotic selection pressure
- MeSH terms
- Duration of Therapy, Anti-Bacterial Agents, Humans, Drug Resistance, Bacterial
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
