Thursday, January 22, 2015

From Quora: Have we already lost the fight against bacterial resistance to antibiotics?

Yes, we have lost the fight, if by "lost" you mean that doctors are no longer able to prescribe antibiotics effectively based on signs and symptoms alone.  This was the case for the first few decades of the antibiotic era, and we came to accept it as normal.

But the vast majority of bacteria are still susceptible to at least one antibiotic, so in that sense we haven't lost.  We just have to change tactics.  Rather than prescribing from a formulary or antibiogram, doctors should order - and pay attention to - lab tests that determine which antibiotics a given infection will respond to.

We have picked all the low-hanging fruit in discovering new antibiotics based on natural compounds, and squandered this bounty with imprudent and wasteful antibiotic prescribing practices.  Those days are over, although far too many doctors do not realize it yet.  However, prudent use of antibiotics combined with good infection control practices will allow us to manage bacterial infectious diseases in the future, despite high levels of antibiotic resistance.

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