case study
Antibiotic Stewardship in Closed Habitat Medicine: Preventing Resistance in a 50-Person Ecosystem: Current Perspectives
Dr. K. Patel
· Lunar Medical Research Cooperative
Lunar Infectious Disease · Vol. 4, No. 3 · October 29, 2023
Abstract
Follow-up investigation building on prior work. Antibiotic resistance emergence in a closed habitat poses existential risk to the community. With a finite formulary and no possibility of same-day resupply, a resistant organism could render an entire antibiotic class ineffective before replacement drugs arrive. We present antibiotic stewardship pr...
Extended analysis and updated findings. Standard antibiotic stewardship principles — reserve broad-spectrum agents, rotate classes, obtain cultures before treatment — apply with heightened urgency in a closed lunar habitat. A community of 50 people sharing air, water, and food represents an ideal ecosystem for resistance propagation.
Our protocols were developed after a near-incident at Shackleton Base in 2027: a urinary tract infection treated empirically with ciprofloxacin was later found to involve a fluoroquinolone-resistant E. coli strain. Had this organism spread to the water supply, the habitat's entire fluoroquinolone supply would have been rendered ineffective.
Key protocols: mandatory culture before empirical treatment when patient stability allows, 48-hour de-escalation review for all broad-spectrum agents, biannual...
Our protocols were developed after a near-incident at Shackleton Base in 2027: a urinary tract infection treated empirically with ciprofloxacin was later found to involve a fluoroquinolone-resistant E. coli strain. Had this organism spread to the water supply, the habitat's entire fluoroquinolone supply would have been rendered ineffective.
Key protocols: mandatory culture before empirical treatment when patient stability allows, 48-hour de-escalation review for all broad-spectrum agents, biannual...
Keywords
antibiotics, stewardship, resistance, formulary, closed habitat, culture