An error of omission rouses Godless from his slumber Orwin and Murtaugh have posted interesting discussions on antibiotic resistance today, and they both seem to be resigned to the fact that bacterial predation can be staved off but not ended. The rise of resistant bacteria seems - to them - to be an inevitable consequence of natural selection. As Orwin puts it:

Are we doomed, then, to fight a continual losing battle? I have thought about this a lot, and I think for the time being, we are. Simply put, human ingenuity is no slouch, but billions of years of natural selection are a pretty formidable foe. Genomics has, and will continue, to give us new targets, and drug companies, finally roused to the danger of multiply resistant pathogens, will respond with new drugs, but if they are based on natural products, as seems likely, then resistance will not be far behind. Of course, many lives will be saved, and this is obviously a good thing, but I fear the dreaded "paradigm shift" is necessary if we ever hope to conquer infectious disease in any significant way. My next post will delve deeper into that last notion, including some cool vaccination ideas and bacteriophage based therapeutics.

I believe that Orwin and Murtaugh have neglect to mention the most important development in the fight against antibiotic-resistant bacteria... namely, pharmacogenomics. As our understanding of human genetics improves, we will be able to personalize drugs to suit our genotypes. A natural consequence of this personalization is a diversity of antimicrobial agents. In practice this will mean that the selection pressures applied to bacteria will be nonuniform, and that a strain resistant to my tailor made drugs will be vulnerable to your personalized drugs. Here's a quote from the ORNL site I linked to:

Pharmacogenomics is the study of how an individual's genetic inheritance affects the body's response to drugs. The term comes from the words pharmacology and genomics and is thus the intersection of pharmaceuticals and genetics. Pharmacogenomics holds the promise that drugs might one day be tailor-made for individuals and adapted to each person's own genetic makeup. Environment, diet, age, lifestyle, and state of health all can influence a person's response to medicines, but understanding an individual's genetic makeup is thought to be the key to creating personalized drugs with greater efficacy and safety. Pharmacogenomics combines traditional pharmaceutical sciences such as biochemistry with annotated knowledge of genes, proteins, and single nucleotide polymorphisms.