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Chan School of Public Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008548","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"wellcome trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"national institutes of health","doi-asserted-by":"publisher","award":["T32AI132120"],"award-info":[{"award-number":["T32AI132120"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"agency for healthcare research and quality","doi-asserted-by":"publisher","award":["K08 HS027841-01A1"],"award-info":[{"award-number":["K08 HS027841-01A1"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosbiology.org"],"crossmark-restriction":false},"short-container-title":["PLoS Biol"],"abstract":"<jats:p>\n                    Understanding how antibiotic use drives resistance is crucial for guiding effective strategies to limit the spread of resistance, but the use\u2013resistance relationship across pathogens and antibiotics remains unclear. We applied sinusoidal models to evaluate the seasonal use\u2013resistance relationship across 3 species (\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    ,\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    , and\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    ) and 5 antibiotic classes (penicillins, macrolides, quinolones, tetracyclines, and nitrofurans) in Boston, Massachusetts. Outpatient use of all 5 classes and resistance in inpatient and outpatient isolates in 9 of 15 species\u2013antibiotic combinations showed statistically significant amplitudes of seasonality (false discovery rate (FDR) &lt; 0.05). While seasonal peaks in use varied by class, resistance in all 9 species\u2013antibiotic combinations peaked in the winter and spring. The correlations between seasonal use and resistance thus varied widely, with resistance to all antibiotic classes being most positively correlated with use of the winter peaking classes (penicillins and macrolides). These findings challenge the simple model of antibiotic use independently selecting for resistance and suggest that stewardship strategies will not be equally effective across all species and antibiotics. Rather, seasonal selection for resistance across multiple antibiotic classes may be dominated by use of the most highly prescribed antibiotic classes, penicillins and macrolides.\n                  <\/jats:p>","DOI":"10.1371\/journal.pbio.3001579","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T13:42:26Z","timestamp":1646833346000},"page":"e3001579","update-policy":"https:\/\/doi.org\/10.1371\/journal.pbio.corrections_policy","source":"Crossref","is-referenced-by-count":31,"title":["Analysis of multiple bacterial species and antibiotic classes reveals large variation in the association between seasonal antibiotic use and resistance"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7647-7169","authenticated-orcid":true,"given":"Daphne S.","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6000-8387","authenticated-orcid":true,"given":"Stephen M.","family":"Kissler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjat","family":"Kanjilal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5400-4945","authenticated-orcid":true,"given":"Scott W.","family":"Olesen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1504-9213","authenticated-orcid":true,"given":"Marc","family":"Lipsitch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonatan H.","family":"Grad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,3,9]]},"reference":[{"key":"pbio.3001579.ref001","unstructured":"U.S. Centers for Disease Control and Prevention. 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