I often hear doctors express concern about antibiotic resistance. Various organizations like WHO also whine about this, calling for restrictions on the use of antibiotics. However, are they right and is it possible to stop this process through such restrictions? I have been asking myself this question for a long time, here are my thoughts on this matter:
Let's consider an isolated system - a Petri dish 
, inside there is a medium and a culture of bacteria, for example, E. coli 
. In the presence of "food" in the medium, these bacteria reproduce until they encounter physical limitations of volume; when such "boundaries" are felt, reproduction stops until a niche for new bacteria is freed up.
Well, they live their lives and do not encounter threats. There is no resistance from the environment (except for the walls of the cup). Then we do “genocide” by adding an antibiotic to the environment (provided that the bacteria are sensitive to it).
An antibiotic can kill the culture completely, but it is more likely that after it there will be some minimal number of surviving bacteria. They will cope with the concentration of the antibiotic, stop dividing for some time, and then start dividing again. And then what Darwin described in the 19th century happens - new generations of bacteria after the antibiotic will be resistant to this antibiotic.
The proverb "What does not kill us makes us stronger" perfectly describes this process.
Moreover, in addition to the antibiotic, any other threats to the bacterial population lead to similar adaptation. For example, if you put bacteriophages (viruses that parasitize bacteria) in a dish, exactly the same thing will happen - part of the population will die, but the descendants of those who survived will have immunity to these bacteriophages.
This adaptation is the principle of evolution of all living things. What, for example, was in the hypothesis of the Red Queen:
“Виду необходимы постоянное изменение и адаптация, чтобы существовать в окружающем мире, постоянно эволюционирующем вместе с ним”
What am I getting at? The point is that we cannot completely abandon antibiotics, nor can we make an antibiotic that kills 100% of the infection population. That is, the adaptation of the infection to the threat is inevitable, regardless of the type of threat. It is a matter of time.
For example, antibiotic-resistant strains always arise in hospitals where antibiotics are used every day, and possibly every hour.
Such a practice leads to constant “training” of the infection, i.e. bacteria mutate in such a way that the threat (antibiotic) is manageable in their next generation. And now a rhetorical question: which hospital can abandon the practice of using antibiotics? People will die if they refuse.
What conclusion can be drawn?
Antibiotic resistance is an inevitable process with the traditional approach to treatment.
For some reason, doctors and other smart guys (from the same WHO) forget or do not understand these fundamental things.
Now I will describe what approach needs to be introduced into medical practice so that antibiotic resistance does NOT create problems. This approach emerges from what is described above - a person is the same organism that can adapt to threats 
. Any infection is a threat. And in this "battle" the winner is the one who adapted first.
Let me give you a simple example: There is a hospital, where they found a strain of tuberculosis bacteria resistant to all antibiotics. We take this strain, go outside and give it to 100 people. Do you think they will all get sick and die or not?
Of course not, some will get sick, and some will not even blink an eye. Why does this happen?
Some of these people have a well-tuned immune system (adapted, has resources), and some do not. You will say that this is logical, but then why does NO ONE check this 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.
I repeat, in modern medicine accessible to mere mortals no one does this! However, they continue to whine that excessive use of antibiotics is to blame.
This approach is stupid at its core, it's like saying that drunkenness is only because vodka is freely sold in stores, we'll ban the sale of vodka and drunkenness will end.
For those interested in this topic, in the video below, a description of the evolutionary experiment on E. coli, which clearly shows everything that I described, and even more: Experience has shown that mutations of E. coli occur with a change of generation, even without threats such as antibiotics , i.e. resistance to antibiotics can arise randomly by changing some genes in new generations!
