Sentence outline

The case for stronger antibiotic regulation


  1. Intro: topic strings
       antibiotics use promotes the spread of bacterial resistance;
       natural selection favors survival/reproduction of resistant
       with regulation, many antibiotics will become effective.
  2. Penicillin example: nine years after its introduction 59% of relevant bacteria were resistant.
  3. Bacteria resist antibiotics by biochemical mechanisms that
       degrade the antibiotic;
       prevent antibiotic from entering the cell;
       alter the antibiotic's target site so it is no longer recognizable.

Resistant bacteria develop in humans and animals

  1. In humans, antibiotics are often either overused -- in response to patient demand -- or chosen poorly -- a broad antibiotic being used when a narrow one would work.
  2. In food animals, antibiotics are also misused as growth enhancing supplements, encouraging the spread of resistance genes.
  3. Moreover, antibiotic resistant bacteria in food animals pass their resistance to bacteria resident in humans and other species.

Overuse has mutiple effects

  1. Multiple-resistance bacteria can arise from overusing single antibiotic.
  2. The resistance of bacteria is proportional to antibiotics overuse (Figure 1).
  3. In the absence of antibiotics, resistant bacteria are at a slight selective disadvantage to those without resistance mechanisms -- that is, their relative population decreases.
  4. This selective disadvantage argues for regulation of antibiotics.

How regulation could work.

  1. First, elimination of antibiotics as growth enhancers for food animals would greatly alleviate the resistance problem, with consequent long-term gains, if short-term costs.
  2. Second, evidence suggests that regulation of antibiotics in human medicine would be successful.
  3. A majority of US physicians support the regulation of antibiotics.