For those who understand that antibiotic delivery selects for resistance, it is not surprising that the international community currently faces a major public health crisis. Notably, many physicians acquiesce to misguided patients who demand antibiotics to treat colds and other viral infections that cannot be cured by the drugs. Researchers at the Centers for Disease Control and Prevention have estimated that some 50 million of the 150 million outpatient prescriptions for antibiotics every year are unneeded. At a seminar I conducted, more than 80 percent of the physicians present admitted to having written antibiotic prescriptions on demand against their better judgment. In the industrial world, most antibiotics are available only by prescription, but this restriction does not ensure proper use.
People often fail to finish the full course of treatment.
Patients then stockpile the leftover doses and medicate themselves, or their family and friends, in less than therapeutic amounts. In the developing world, antibiotic use is even less controlled. Many of the same drugs marketed in the industrial nations are available over the counter. Unfortunately, when resistance becomes a clinical problem, those countries, which often do not have access to expensive drugs, may have no substitutes available. The same drugs prescribed for human therapy are widely exploited in animal husbandry and agriculture.