Modèles expérimentaux : quels modèles peuvent encore apporter des informations dans le traitement des infections bactériennes ?

Experimental models of infection provide essential information for the optimal use of antimicrobial agents and the treatment of bacterial infections. Simple models of thigh or lung infection in mice allow to determine the pharmacokinetic-pharmacodynamic parameter that is predictive of in vivo efficacy and therefore to give recommendations for optimal dosing of antimicrobial agents in human. These models can also define breakpoints classifying bacterial strains as susceptible or resistant based on in vivo observations. For the study of investigational molecules, more discriminating models such as endocarditis, osteomyelitis, pneumonia or meningitis in rats or rabbits can be used to compare the anti bacterial efficacy to the effect of the reference treatment and to study tissue distribution. Experimental models of infections are of major interest to investigate the impact of a given mechanism of resistance on the activity of antimicrobials, in terms of bactericidal effect and emergence of resistant mutants. Finally, the experimental approach remains the finest one to study the potential interest and the mechanism of the benefice of a combination of antibiotics or a combination to a non-antibiotic treatment.