Dr. Arjun Srinivasan: We’ve Reached “The End of Antibiotics, Period”

Those examples both qualify as necessary and emergent.

What's been happening for decades is things like kids getting a cold and doctors wanting to appease panicked parents by prescribing an antibiotic (that's obviously going to do nothing to a virus).

... and the judicious use of antibiotics requires some kind of regulatory agency or system to make sure the users follow through.

This seems like another area where libertarianism is crashing against the rocks of reality-- as socialism, communism, and all other political ideologies have already done. I have a profound sense that all political ideologies are failed, and that we're entering a post-ideological age of pragmatism driven by either populism, oligarchy, or technocracy... take your pick.

The anthropomorphism of bacterial evolution makes the article hard to follow for the layman (me). Can someone familiar with bacterial evolution please explain to me how the use of antibiotics leads to superbugs? I am clearly misunderstanding something.

I was under the impression that in a population of bacteria, genes express themselves in any number of random ways. If we expose the bacterial culture to antibiotics, the bacteria susceptible to the antibiotic dies, while the resistant bacteria lives on free to reproduce, leaving the descendant bacteria with resistive characteristics...

My question to the HN scientists is, doesn't this just destroy some subset of bacteria? Is new genetic information produced that did not exist before? Taking this trimming tree down the line, wouldn't the "superbug" antibiotic resistant bacteria have been created/survived and thrived anway? Or does the antibiotic exposure actually cause, "the bacteria to want to survive", in the sense that exposing them to antibiotics leads to more rapid mutation of descendants? Why wouldnt the antibiotic resistant bacteria be created with or without overuse of antibiotics? Isn't the spectrum of the genetic tree just trimmed?

What I'm saying is that we should have treated antibiotics, as a worldwide community, like a stockpile with a finite lifespan and only a limited availability. As few uses as possible, with the goal of saving lives, not making people "feel better".

What I'm imagining is something like the Department of Energy, or even the CDC here, regulating the ability to prescribe antibiotics and establishing rules that must be followed for their use. Antibiotics would not be a privately exchanged commodity, but a highly regulated resource managed for the public good.

So, would this hypothetical future involve antibiotics for your hypothetical cases? Probably? Possibly? If doctors discerned that the cause of the swelling was bacterial infection, if the bladder infection was threatening to the wife's future well-being? Then I'd suppose so.

But you wouldn't get antibiotics just for being alive like you do now. They practically hand them out like candy at doctor's offices.

Oh, you have a cough? Have a z-pak. Doesn't matter if it's a viral infection going around, who cares if giving you this drug just ensures that some day in the future we won't be able to treat someone who is actually dying with azithromycin. What's important is that taking these pills will make you feel like we're doing something to help.

You are completely right in that bacteria don't have the ability to "want" things since they don't have any kind of brain. However, desire is a useful way for the general public to understand what is happening. It's like saying "Water wants to flow to the lowest point of a room" or "The arrow wants to follow the path of least air resistance"