[retrac]

Like many slow moving disasters, it doesn't feel like one while you live through it.

An example: gonorrhea has no golden standard cure anymore. 40 years ago a single large dose of oral antibiotics was an effective cure. It made controlling it relatively easy. In the 90s, resistance to most of the common oral antibiotics became prevalent. Through the 2010s, a single dose of an intramuscular cephalosporin was effective. Now resistance to that is also common. Gonorrhea remains curable in almost all cases, but cultures and strain-specific targeting and second-line antibiotics in combination may be needed. Repeat testing to be sure it worked is necessary.

From one pill cure in 99%+ of cases, to something requiring multiple clinic visits and lots of lab work and possibly IV infusion antibiotics. The complications for public health, in terms of patient compliance, containing spread, as well as just the labour hours and case management complexity, are awful.

[dmckeon]

Also 40 years ago, 40-some years after penicillin was introduced, gonorrhea had evolved to produce an enzyme that acted specifically against it, penicillinase. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1046026/pdf/brj...

No matter how many new, different, or even radical antibiotics we develop, unless we get ahead of over-prescribing and under-treating (not taking all of a prescribed treatment course) we will continue to rapidly evolve more successful micro-organisms, to our own detriment.

[midoridensha]

I think it's utterly hopeless. With billions of humans, there's no way to get everyone to agree to do the right thing, both with doctors and especially patients. You just need a small fraction doing the wrong thing for something bad to evolve: look at Covid, for instance. That simply evolved somewhere at one point in time in one place, and then spread like wildfire.