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Comment by rjurney | Hacker News Reader

Yes. If it takes 30 years for this drug to become resistant, but 5 or 10 for other antibiotics... then a sound strategy is to use the long-lasting drug, and save the drugs with a shorter lifespan as second, or third tier. This will slow the development of resistance, so they will last longer, and we'll have a broader range of working antibiotics at any given time. Which means more infections successfully treated, and more lives saved. Win!

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If we eliminated treatment with drugs with resistances against them, we'd no longer be artificially selecting for those bacteria, which would mean the bacteria that naturally performed better would be the most likely to survive.

Essentially if we stop treating with the drugs with resistances against them, we'd eventually end up with a bacteria gene pool that resembled the original pre-resistant one, where resistant bacteria were replication errors that were drowned out by natural selection.

The only issue is we can't do that without sacrificing millions of lives. So having a drug that works via completely different mechanisms would fulfil both.

This is exactly what we've been doing for decades. When you get an antibiotic-resistant infection, like I have twice, they just give you older antibiotics. So the more antibiotics you have, the better, because it's harder for a bacteria to be resistant to more and more antibiotics at once.

Well, they give you more toxic antibiotics that may be older but that have too many side effects for routine use.

Yeah, sulfa wasn't very much fun for me.

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