Inevitable Resistance

Abstract

Abstract Pathogens are evolving drug resistance at a faster rate than humans can develop new medicines. At these rates, it is quite possible that the human species may be moving toward a post-antimicrobial era. This chapter begins by examining the evolution of antibiosis and its countermeasures as well as the parallel histories of antimicrobial drug development among human hosts and the accelerated evolution of antimicrobial resistance among pathogens. The latter trends are certainly driven by prescription and consumption practices, which are further challenged by issues of aging and poverty. However, the rise of resistance is even more impacted by the misuse of these drugs as growth factors in commercial agriculture. At the level of international policy, a One Health approach may help to mitigate the problem or possibly reverse these trends. Examples include MRSA, malaria, VRSE, and MDR/XDRTB as well as lessons drawn from the history of smallpox vaccination.