ISTOCK, SMARTBOY10In his 1945 Nobel Prize lecture, Alexander Fleming included the directive, “If you use penicillin, use enough.” Some 70 years later, clinicians and researchers still aren’t always clear on what that means. Surprisingly little is known about how treatment regimens influence the emergence of antimicrobial resistance, both in individuals and in the wider human population.
“It’s quite shocking that we have such a poor knowledge base given how important this is,” says evolutionary biologist Andrew Read of Pennsylvania State University. “It’s hard for me to think of another area of medicine where it impacts almost everybody’s lives and yet we have so little experimentation.”
For some diseases, such as tuberculosis or staphylococcal blood infections, completing the full course of antibiotics is known to be important for making a full recovery. But for other pathogens, the optimal dose is less clear, and despite the dearth of evidence, physicians regularly encourage people to complete their full course of antibiotics to prevent the spread of resistance.
“That’s never made any sense to me. Why would resistance arise if you stop using your antibiotics?” ...
