An integrative model finds comparable contributions to drug resistance from poor drug adherence and adapting bacteria

Antibiotic resistance is a compound effect of several factors in the infection to healing cycle, from molecular factors such as mutation rate of bacteria to habitual behaviors such as adherence to a prescribed drug. Usually each of these factors is modeled separately from biochemistry, evolutionary biology or population health perspectives. To develop an understanding for the drug resistance at a population level, which is of high global significance, it is important to weigh all these factors in an integrated model. We develop RASAID, a model for resistance considering bacterial adaptation, infection spread, population adherence, immunity, and drug dosage. We apply the model to antibiotic resistance in the spread of resistant strains of Streptococcus Pneumoniae ( Sp ) in a finite community. We analyze the contributions from several factors to resistance, with a goal towards asking how important is the pursuit of newer drug developments relative to improving the awareness about the good practices in drug usage.