Could antibiotics (especially anti-resistant antibiotics such as this) be used in a phased manner worldwide to help prevent resistant bacteria from gaining a foothold?
Say a couple similarly potent (a few vectors to kill bacteria) antibiotics are found in the next 20-30 years. If the WHO encouraged/mandated that drug A was prescribed for the first 10 years, B for the next, then C before going back to A could we "confuse" the bacteria?
The theory is sound [1], but as in many situations with a lot of different actors, you get some coordination problems. Already many countries have some rules about how and when you can use certain anti-biotics, and some countries completely ignore them, or ignore them when it's profitable (farmers, usually, from what I gather.[2])
Even given the variety of anti-biotics we have now, if they were on a kind of 4 or 5 year rotation schedule that was actually followed, given the reproductive rate of bacteria i suspect that would work anyways, so hoping for coordination would certainly help, a solution that wouldn't require humans being more cooperative would be greatly expanding the diversity of our anti-biotics.
Out of curiosity, is there a reason antibiotic cocktails aren't used more often? Cost?
Seems like it would be more productive and play to human nature if we could decrease the cost of cocktails and mandate that they're always used instead of singular antibiotics.
I think a big part of it is that single antibiotics have been quite effective. So there isn't a developed practice of using cocktails and the interactions and so on aren't necessarily well tested/understood.
The most recent course of antibiotics I took was a combination of antibiotics though, so it's changing.
When considering the axis of creating super bugs, cocktails would probably exacerbate the problem, since now you're applying several stressors in parallel. Unless you had like, 5 or so fundamentally different avenues of attack, then you could get, what, 30~ unique combos? Most people don't need anti-biotics more than 10 times in their life? If it they were equally valid in any case, doctors could just choose randomly from the set of cocktails they haven't used on a given patient before. I'm certain a cell biologist would tell me this is a dumb plan for some reason, though.
It would help. But when they are patented, the structure is in the open and anyone with good knowledge of synthesis can produce them, e.g. for treating livestock in China or for sale on the grey market in India.
Or for treating livestock, chest pains and flu symptoms in America. Don't forget you'd need the government on side and America's doesn't have a good track record of cooperating with the rest of the world for the global good.
Say a couple similarly potent (a few vectors to kill bacteria) antibiotics are found in the next 20-30 years. If the WHO encouraged/mandated that drug A was prescribed for the first 10 years, B for the next, then C before going back to A could we "confuse" the bacteria?