People who suffer from unexplained / untreatable diseases like arthritis or MS might get some relief, while there would be an added pressure on the pharma industry to innovate in antibiotic development by accelerating the loss of existing antibiotic efficacy through the evolution of resistance.
You want to cause current antibiotics to be less useful so pharma will invest more? Just allow generic versions.
If you want to pressure the pharma industry use laws.
Some antibiotics do have a good enough safety profile that such occasional speculative use would be a good tradeoff. Elderly people are also the one group least able to handle infections! Others do not.
You're joking, right?
Total antibiotic resistance is what we're trying to minimise, remember. You're proposing to achieve that in the long term by making it worse in the short term, but the only way that makes sense is if there is actually an abundance of new antibiotics "out there" waiting to be discovered, and the binding constraint currently limiting their development is that pharmaceutical companies can't be bothered researching them. But that is obviously not true -- steadily growing resistance has raised alarm for decades, and any pharma company that could produce a genuinely new antibiotic today would make immediate bank.
IOW, the incentives are already there and they aren't helping, so why take the extra step of making things deliberately worse?
This is another one of those schemes for getting a bunch of people killed in the service of medical crankery, isn't it.
That is misleading. When a clinical trial is designed for non-inferiority, it doesn't say anything about being superior or equal. Just as legally, a defendant is either guilty or not guilty - there is no legal adjudication of being "innocent".
These drugs are not comparable (different stability profiles, different mechanisms of action, etc) and to say they're equal is highly misleading.
>and the absence of the drugs that would have been discovered since then has surely killed many more people than the inadvertent use of harmful drugs ever could have.
There is no evidence that safety regulations have denied us some miracle drug. I don't want the FDA approving drug products that are harmful to the general population. You haven't made a good argument for "the greater good" besides a reference to magainin, a product for topical treatment of foot ulcers. There are thousands of known anti microbial peptides.
Well, of course we don't know of a specific miracle drug they've denied us, because it isn't until after a drug is in wide use that you find out whether it's a miracle drug or not. But we can see that there were enormous numbers of miracle drugs in the 20 years immediately preceding the safety regulations, and almost none in the 63 years since then. There have definitely been some† but a very large slowdown is clearly evident if you look at the history. Most of even the important new drugs since then are slight variations on previously known molecules.
A reasonable inference from these observations is that safety regulations have denied us a lot of miracle drugs.
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† zidovudine, Paxlovid, oral rehydration therapy, ivermectin, propofol, SSRIs, sildenafil, acyclovir, misoprostol, ritonavir, and arguably buprenorphine come to mind; and time will tell whether lovastatin and semaglutide belong on this list or on the failures list with fen/phen and heroin.
Maybe you disagree, but I don't think infliximab or even rituximab is close to the same level of importance as things like penicillin, Thorazine, misoprostol, or oral rehydration therapy. Insulin is, and it's technically a biological, but it was pre-01962.
I listed the three antivirals I think were revolutionary rather than evolutionary (all of which were post-01962), and I did list lovastatin, which was the first statin available, and widely applicable, and therefore the revolutionary one.
Because so much of 20th-century drug research happened in the US (because the US had capitalism) the clinical-trials requirement and the Drug War there had an outsized effect, and other countries copied them afterwards.
One particular case that I studied was Zasloff's "magainin": https://en.wikipedia.org/wiki/Magainin which was denied licensing even though the clinical trials found that it was both safe and effective. The problem was that it wasn't more effective than the existing standard of care; it was only equally effective.
It seems certain that the Kefauver–Harris Drug Act has prevented innumerable cases of useless or harmful drugs from being marketed. But, looking at the history of drug development, it also seems clear that the rapid drug development in the decades up to 01962 virtually halted at that time, and the absence of the drugs that would have been discovered since then has surely killed many more people than the inadvertent use of harmful drugs ever could have.