How Do We Measure Success in Combatting Antibiotic Resistance?

A recent article describes how China is trying to crack down on its egregious antibiotic misuse:

The rise of “suberbugs,” lethal germs that can’t be zapped by most antibiotics, owes particular thanks to China, where antibiotics are handed out like throat lozenges because hospitals depend on overprescribing them to make money. That’s part of why some scientists think deaths from infection could soon hit levels not seen since the early 20th century.

What saves the world from that fate could be this: In 2011, China’s ministry of health started cracking down on antibiotics overprescription, applauding hospitals that complied, and publicly shaming those that flouted its new protocols. Now there’s evidence the plan is working. A new study (pdf) by doctors at Zhejiang University reports that the percentage of hospitalized patients who were prescribed antibiotics fell from 68% in 2011 to 58% by the end of 2012. For outpatients, that proportion dropped from 25% to 15%.

This is good policy, but shouldn’t success be measured by a decrease in the frequency of antibiotic resistance? I’m guessing if those trends were good, we would be hearing about them. Hopefully, these measures will work, but it might be too late for certain kinds of resistance in certain organisms, where resistance doesn’t impose a fitness cost (or such costs have been eliminated via natural selection).

Fewer resistance organisms is the north star in all of this.

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