[xpinguin]

Do you really think, that general populace's misuse of antibiotics could cause the development of resistant bacterial strains en masse?

I might be wrong, and if so, please don't hesitate to provide some factual paper, yet my intuition suggests that in order to obtain solely by selection (under the pressure of a _single_ bioactive substance), a bacterial strain, that is, simultaneously:

- resistant to the aforementioned substance

- stable: resistance is not lost after the generation or so, past the moment when exposure is over

- contagious: strain is resistant to different immune systems (w/o losing its resistance to the substance, of course),

one either needs to perform a directed selection (eg. like that for apple-trees), or to create an environment, where really _huge_ bacterial population could thrive and persist for a long time: like that in hospitals or farms, - where not only frequent turnover of living organisms along with the regular exposure to antibacterial substances do happen, but also some intermediate vessels (medical instruments, ground, water supply, etc.) are available for bacteria to flourish in-between living hosts.

[croatially]

> Do you really think, that general populace's misuse of antibiotics could cause the development of resistant bacterial strains en masse?

Of course not. There's 7 billion people, and just a tiny percentage uses antibiotics.

There's around 60 billion land mammals raised by humans every year, throughout their life most of them use the strongest antibiotics. It speeds up growth, it prevents silly deaths, increases profit.

Diseases, plagues will come from livestock, as they always did, not from humans.

[dbrazel]

In the absence of antibiotics, there is selective pressure to eliminate the genes or mutations that confer resistance. However, there are opposing factors - antibiotic resistance genes are often carried on plasmids, independent genetic elements that can be exchanged between bacteria. Plasmids that contain antibiotic resistance genes frequently also contain heavy metal resistance genes[1]. This allows for co-selection, where the presence of, for example, mercury pollution from coal-fired power plants will maintain antibiotic resistance in antibiotic-free environments[2,3]. Plasmids can act as parasites on their bacterial hosts - many carry pairs of genes that encode both a toxin and a less stable antitoxin. If the plasmid is lost, the bacterium will die[4]. All of these mechanisms can maintain antibiotic resistance without antibiotic exposure.

[1]: http://www.cell.com/trends/microbiology/abstract/S0966-842X(...

[2]: https://link.springer.com/article/10.1007/s00284-012-0194-4

[3]: http://www.tandfonline.com/doi/abs/10.1080/01490450902889072

[4]: http://www.annualreviews.org/doi/abs/10.1146/annurev.micro.5...

[specialist]

I think bad policy leads to bad outcomes. When people are given good information, they make good decisions, on the whole.

As a parent, I was pretty pissed off when I learned that over use of antibiotics harms my child, my society.

As a citizen, I'm pretty pissed off that (one aspect) of the opioid epidemic is because doctors changed pain management protocols, without any followup testing, assessment.

“We started it”: Atul Gawande on doctors’ role in the opioid epidemic

https://www.vox.com/2017/9/8/16270370/atul-gawande-opioid-we...