I often hear medical professionals express concern about antibiotic resistance. Various organizations, such as the WHO, also complain about this, calling for restrictions on antibiotic use. But are they right, and can this process be stopped through such restrictions? I've been pondering this question for a long time, and here are my thoughts on the matter:
Consider an isolated system—a Petri dish 
—containing a medium and a bacterial culture, such as E. coli 
. When food is present in the medium, these bacteria reproduce until they reach the physical limits of their volume. Once these "boundaries" are reached, reproduction stops until a niche becomes available for new bacteria.
So, they're living their lives and facing no threats. There's no resistance from the environment (except for the walls of the dish). Next, we perform "genocide" by adding an antibiotic to the environment (assuming the bacteria are sensitive to it).
An antibiotic can kill a culture completely, but it's more likely that a minimal number of surviving bacteria will remain. They'll cope with the concentrated antibiotic, pause in their division for a while, and then begin dividing again. And then what Darwin described back in the 19th century occurs: new generations of bacteria exposed to an antibiotic will become resistant to that antibiotic.
The proverb "What doesn't kill us makes us stronger" describes this process perfectly.
Moreover, besides antibiotics, any other threats to a bacterial population lead to similar adaptations. For example, if you place bacteriophages (viruses that parasitize bacteria) in a dish, the same thing will happen: part of the population will die, but the descendants of those that survive will be immune to these bacteriophages.
This adaptation is the principle of evolution for all living things. This, for example, was the point of the Red Queen hypothesis:
“Виду необходимы постоянное изменение и адаптация, чтобы существовать в окружающем мире, постоянно эволюционирующем вместе с ним”
What's the point of all this? The point is that we can't completely abandon antibiotics, nor can we create an antibiotic that kills 100% of the infectious population. This means that infection adaptation to a threat is inevitable, regardless of the type of threat. It's a matter of time.
For example, antibiotic-resistant strains always emerge in hospitals where antibiotics are used daily, and perhaps hourly.
This practice leads to constant "training" of the infection, meaning bacteria mutate so that the threat (antibiotic) is more manageable in their next generation. Now, a rhetorical question: what hospital could abandon the practice of using antibiotics? If they do, people will die.
What conclusion can be drawn?
Antibiotic resistance is an inevitable process with traditional treatment approaches.
For some reason, doctors and other smart people (like those at the WHO) forget or don't understand these fundamental things.
Now I'll describe the approach that needs to be introduced into medical practice to ensure that antibiotic resistance does NOT become a problem. This approach stems from the principle described above: humans are organisms that can adapt to threats 
. Any infection is a threat. And in this "battle," the winner is the one who adapts first.
Let me give you a simple example: There's a hospital where they've discovered a strain of tuberculosis bacteria resistant to all antibiotics. We take this strain, go out into the streets, and give it to 100 people. Do you think they'll all get sick and die?
Of course not. Some will get sick, and others won't even blink. Why does this happen?
Some of these people have well-adapted immune systems, while others don't. You might say this is logical, but then why isn't anyone testing their immunity upon admission to the hospital?
After all, knowing that the immune system is not ready for infection, it can be influenced in advance and the risk of death from an antibiotic-resistant strain can be eliminated.
Let me repeat, no one in modern medicine accessible to mere mortals does this! Yet they continue to complain that the overuse of antibiotics is to blame.
This approach is fundamentally stupid. It's like saying that drunkenness is caused by the free availability of vodka in stores. Ban the sale of vodka, and drunkenness will end.
For those interested in this topic, the video below describes an evolutionary experiment on E. coli, which clearly demonstrates everything I've described, and even more: Experiments have shown that mutations in E. coli occur with generational change, even without threats like antibiotics . That is, antibiotic resistance can arise randomly through the replacement of certain genes in subsequent generations!
