There has been a lot of coverage in recent years on the topic of “Bad Bugs, No Drugs”, along with some concerted pressure on governments to fund greater research into the development of new and original antimicrobials.

The focus on this as an absolute priority sits a little uneasily with me…. The idea that when we have “prescribed to death” one broad spectrum antimicrobial, another one (even broader spectrum) will just fill its place seems to me a little short-sighted, and I think does little to support good anti-microbial stewardship.

I would like to think that there is not subtle pressure for such lobbying from pharmaceutical giants.

Bacteria are not stupid. For many reasons, they are the masters of adaptation and survival. They were amongst the first living organisms on the planet, and I am sure they will be among the last.

You can be sure that bacteria will quickly acquire a means to counteract any new antimicrobial agent. (Interestingly though generally not all bacteria in the population will become resistant. This is likely due to open systems and equilibriums which I will discuss in a later article.)

I am not saying there should be no further Research and Development of new anti-microbials. Of course there should. I am just saying that I think the focus should very much be on making the best use of our currently available agents, not relying on new ones to magically come along at regular intervals.

The primary aim should be to “tame the dragon”, not to hunt it…

Michael