MRSA is already drug resistant. That's what the MR bit is - methicillin resistant.
> Probably the worst culprit is the abuse of antibiotics in factory farming.
That's certainly a problem, but misuse of antibiotics in humans is still a big big problem.
Antibiotics were routinely used for illnesses where they shouldn't have been - ear infections, viral coughs and colds.
In developing nations people often use antibiotics in the worst way - a short course until they feel better, not a long course until the bacteria are all killed. This is partly because they don't know any better and partly because they buy what they can afford.
> In developing nations people often use antibiotics in the worst way - a short course until they feel better, not a long course until the bacteria are all killed. This is partly because they don't know any better and partly because they buy what they can afford.
This brings up an important topic in infectious diseases right now: in many cases, long courses of antibiotics increase selective pressure and favor the antibiotic-resistant bacteria. One strategy to reduce drug resistance is to (rationally) minimize duration of treatment [1]. This isn't to say that medication nonadherence is good, but it is to say that the field is moving towards a shorter duration of treatment for many infections.
Yeah, I've always been suspicious of the phrase "until the bacteria are all killed". It sounds like a pleasant rationalization than an elegant simplification of the argument.
> In developing nations people often use antibiotics in the worst way - a short course until they feel better, not a long course until the bacteria are all killed. This is partly because they don't know any better and partly because they buy what they can afford.
I wish I could say this was limited to developing nations.
>Antibiotics were routinely used for illnesses where they shouldn't have been - ear infections, viral coughs and colds.
In developing nations people often use antibiotics in the worst way - a short course until they feel better, not a long course until the bacteria are all killed. This is partly because they don't know any better and partly because they buy what they can afford.
On the contrary, I would like to point out that its not limited to developing nations. When I first arrived in the US, one of the advice that my US settled relatives gave me was that American doctors routinely prescribe antibiotics even for the simplest illness. This fact was confirmed when I took my Mum to a doctor when she felt unwell when visiting me: light fever, and the prescription was some very potent antibiotics. My mother refused to take them and got better on her own after a few days. There seems to be a reluctance to take antibiotics in my family.
I think another huge trend worth noting is the use of anti-bacterial products. They do nothing other than killing a large portion of both good and bad bacteria indiscriminately and leaving a small, drug-resistant strain, which then does not have to compete for resources with all the non-resistant bacteria and reproduces freely to ultimately make people sick.
I think most of those products are anti-bacterial by virtue of things like extremely high alcohol content. I could be wrong, but I don't expect bacteria to develop a resistance to 93% ethyl alcohol any more than I expect bleach- or hydrochloric- resistant bacteria.
Yes, the big problem with triclosan is that it's a water pollutant. This is why I've stopped using it.
That said, I think the concerns about antibacterial hand soaps leading to resistance are overblown. The bacteria on your hands are not an isolated population; you're exchanging bacteria with the environment all the time. Applying intermittent selection pressure to a tiny fraction of a population at a time causes little if any genetic drift in the entire population.
Say you wash your hands with triclosan soap, and all but a few bacteria are killed. When those bacteria are transferred to a doorknob, say, they have no advantage against the other bacteria that are already there; indeed, whatever mutation allowed them to survive the triclosan probably puts them at a disadvantage in a triclosan-free environment. Even the ones that stay on your hands don't have a competitive advantage against newcomers until the next time you wash.
Conversely, the bacteria in your body are an isolated population. When you subject them to strong selection pressure by taking an antibiotic, if any manage to develop a little resistance, they continue to have an advantage as long as you're taking it. If you don't take enough to kill them despite their resistance, you'll wind up with a pretty pure population that has this new level of resistance. Pass that to a few other people, and repeat the process a few thousand times, and you have a problem.
Though less prevalent, even people in developed countries do this (short course). Slightly off-topic, but with the "complete" and "short" courses now available (e.g., a complete lasts only 2-3 days), how is resistance affected? Is it better, worse, or the same? Better, since people are more likely to complete a course?
> Probably the worst culprit is the abuse of antibiotics in factory farming.
That's certainly a problem, but misuse of antibiotics in humans is still a big big problem.
Antibiotics were routinely used for illnesses where they shouldn't have been - ear infections, viral coughs and colds.
In developing nations people often use antibiotics in the worst way - a short course until they feel better, not a long course until the bacteria are all killed. This is partly because they don't know any better and partly because they buy what they can afford.