> The antibiotic resistance most likely predates widespread pharmacological usage

This is absolutely not true, see this very accessible peer-reviewed primary source for many historical examples of antibiotic resistance driven by modern medicine [1].

Here is an excerpt from [1]:

- "After a new drug is introduced, drug resistance can rapidly evolve, leading to treatment failures [12]. For instance, most Staphylococcus aureus isolates in British hospitals were resistant to penicillin just 6 years after the introduction of the drug [13]"

[1] Why does drug resistance readily evolve but vaccine resistance does not? https://royalsocietypublishing.org/doi/pdf/10.1098/rspb.2016...

> This is absolutely not true

I’m not saying modern medicine didn’t put a ton of evolutionary pressure on antibiotic resistance. However, there’s some evidence of AR genes being present in the microbiomes of previously isolated tribes [1]. So we didn’t promote the “invention” of AR by bacteria, but likely just accelerated the selection of AR strains.

1. 10.1126/sciadv.1500183

I see, thanks for elaborating and providing the citation - very interesting paper indeed. "This is absolutely not true" was not a charitable/informed interpretation of your comment, my apologies.

> So we didn’t promote the “invention” of AR by bacteria, but likely just accelerated the selection of AR strains

Well put, we are in agreement.