All Things Considered this afternoon had a brief story about MRSA (methicillin-resistant Staph aureus), so here's a brief response:
The story discussed the fact that MRSA seems to be present in community-acquired skin infections on a more regular basis. Rather than sticking to ICU's and drug-using groups, it's been diagnosed in suburbia. However, while the strain in the hospitals is famously pan-resistant, the community-acquired strain is susceptible to the old drugs that are hardly ever useful anymore.
The narrator seemed suprised by this. I am not.
If you hit a group of bacteria with 3rd and 4th generation antimicrobials, the resistance to those drugs will become predominant thanks to selection pressure. If you don't challenge them with the old stuff (penicillin et. al.), that selection pressure is not there; hence, resistance to those strains (if it is independent of other resistance factors) gives no special advantage and may very well go away.
How many suburban kids are getting straight penicillin these days?
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