Afterword: A Course of Action

The continuing hope of many infectious disease experts is that the pharmaceutical industry will temporarily stave off the inevitable by producing new classes of antibiotics. That would keep us one step ahead of the pathogens. However, three fundamental problems stand in the way. First, if new, highly effective compounds were produced, the medical community would restrict their use to avoid loss of efficacy through emergence of resistance. In the absence of sales, little profit can be made. Second, staying only one step ahead of the pathogens is not enough. Pathogen populations are often so large that subpopulations have already moved that first step toward resistance. A third problem is that as a community our antibiotic treatment protocol....