Resistance economics: social cost and the evolution of antibiotic resistance

Abstract

Daily and Ehrlich have described the current state of our epidemiological environment in chilling detail. While their point is that human beings interact and affect the epidemiological environment in a variety of ways, the development of antibiotic resistance in bacteria strikes us as one aspect that we can begin to analyse immediately. The evolution of resistance to antibiotics is a function of their use by humans. The more we use, the more selective pressure is placed upon bacteria to develop resistance. This is further complicated by how they are used. Both the duration and the amounts used affect the change in the level of resistance. Finally, the primary feature driving the concern over the use of these drugs is that the evolution of resistance makes these ‘miracle’ drugs exhaustible. We can try to develop new and better antibiotics, but it is uncertain how successful we will be and how expensive they will be if we are successful.