Are drug company executives humans ^_^?
Because one of the biggest problems in bringing new ones to market is that after you've spent more than a strategic bomber getting them there, they're put on last resort lists ensuring they won't get prescribed often. To even come close to breaking even they have to have seemingly insane prices, which gets them horrible PR for the crime of saving lives in a system that's stacked against them.
Why bother? I'm sure a lot do because they don't want them and their's dying from a superbug in the future, but they've still got to keep their company out of bankruptcy.
It's hardly dire, and arguably the disaster headlines of each new MRSA strain is more damaging to public awareness about how antibiotics actually work.
New antibiotic finds are black swan events, they tend to come from new areas that unless you specifically are looking there, you're not going to find. It's like an oil well, and the usage of the the few "last-resort" antibiotics, which ones get produced and sold, is highly controlled by a handful of pharma companies so they eke out whatever monetary value is left.
[1] http://www.nature.com/nature/journal/v517/n7535/full/nature1... https://directorsblog.nih.gov/2015/01/13/digging-up-new-anti... http://www.the-scientist.com/?articles.view/articleNo/41850/... http://www.npr.org/sections/health-shots/2015/01/07/37561616... http://www.smithsonianmag.com/science-nature/new-antibiotic-...
I am familiar with Lewis group and and wish more people were also. Thanks for the links, as its nice to see the background for those not familiar. Definitely worth an upvote IMHO.
My concern with this the belief that this is is a steady march where "New resistant strains and new antibiotics to fight those strains is a constant inevitable march of evolution" implies there is no need to be concerned. New technology may save lives, just as unproven carbon neutralizing tech may stop green house issues, but today, at this moment, there is no proven tech that obviates this dangers. While, we hope and believe, that new tech will solve many problem, the widely held scientific view point on AMR is that it is an unsolved problem that is going to kill a lot of people. Which IMHO is pretty dire.
But always complete your antibiotic prescription.
How this can possibly contribute to the spread of antibiotic resistance is mystifying to me, as is the basis of this advice - is there ANY evidence that patients not completing their drug courses causes resistance?
As I learned as a rule of thumb while doing microbiological research in a NSSF Summer Science Training Program in 1977, most random antibiotics would fail to kill E. Coli at a rate of 1 in a million, and it went up to 1 in a billion with streptomycin (this is with random mutations, no plasmid acquisition involved, which is another story).
However, these surviving bugs are generally not as fit as wild type, they've probably survived by sacrificing something, or doing something that consumes more energy. This helps your immune system mop them up, and note if antibodies are involved (don't know about that) it takes a while to come up with new ones, plus if there's any sort of bacteria ecology in the target area that survives the antibiotic they'll out-compete them.
It shouldn't take much research on your part to confirm the basics of what I've related above, it's a tremendous problem, especially with TB, who's defenses require long and obnoxious drug schedules, resulting in more and more MDR and XDR (multi- and extensively-drug resistant) strains.
If you get XDR, you're probably going to die, in a era where that's squalid instead of romantic.
And I just came across "Totally drug-resistant tuberculosis" https://en.wikipedia.org/wiki/Totally_drug-resistant_tubercu... Not official yet, but....
Remove that pressure, and the resistant population has a chance to rebound. More likely than having an ecology of other bacteria to fight with is that the field is somewhat or all but completely cleared. The body may not also have had a chance to clear up whatever condition allowed it to get a grip in the first place. Etc.
Again, as I understand it TB is a great example to look at, and depending on where you live it might even be a real danger to your and yours, so maybe read up on it?
Low doses allow you to provide a continuous challenge that doesn't kill the entire population. That's not what's happening when you stop your drug course early.
If it were true that resistant phenotypes often ARE dramatically less fit to the degree you imply we could simply stop taking Antibiotics and everything would revert back to it Susceptible state.
When you stop a dosage early you've very likely applying a low dosage to some subpopluation. Dosages are not linear, nor evenly applied throughout the entire population of bacteria in a human body.
We've been on the cusp of an antibiotic resistance epidemic (according to the media and select physicians) for decades.
1979 - http://www.ncbi.nlm.nih.gov/pubmed/45521
1992 - http://science.sciencemag.org/content/257/5073/1064
But, as @reasonattlm said far more eloquently than I: humans seem need these stories to provide the motivation to use existing antibiotics less and to get moving on creating new antibiotics.