As in ICU physician, I see a lot of cases of infection with drug-resistant bacteria. The excellent piece in Slate neglects two important points. One is the old saw of using anitbiotics ONLY when indicated, that is not for "colds" and what we call "upper respiratory infections" such as bronchitis, which usually don't get better with antibiotics.

The other, more difficult task, is to use indicated antibiotics for less time. How long should a patient with an infection receive antibiotics? With a few exceptions, we just don't know. We choose an arbitrary length of treatment (say, 10 days, 14 days), but only rarely are these decisions driven by empiric data. The less time a patient receives antibiotics, the lower the probability of a bacteria developing resistance (in theory, anyway).

In the medical community, we need to do more research to help us make decisions about when it is safe to stop a course of antibiotics, and also better data on when antibiotics are really indicated.

But isn't it also crucial to use antibiotics until the primary infection is eradicated? I was under the impression that a lot of bacterial resistance has been brought about by people using antibiotics for too little time (only until they start to feel better, not until the bacteria are actually gone). Is this wrong?

Still, something has to break. There are so many drug resistant bugs that we are going to have to come up with something different.

Not all of us can take antibiotics. Thanks to an idiot doctor's refusal to take out my tonsils when they were infected one week out of five, I can no longer take penicillin. Thanks to growing up in the 60s, when antibiotics were used for everything, I am also allergic to tetracycline, sulfa and most macrollides. I can still take Cipro, but that is the only one.

It's also almost impossible to convince nurses, doctors and other medical staff that I'm serious when I say that, too. A nurse looked at my chart, read my Medic-Alert, then tried to smear Polysporin on an incision last year. I had to grab her arm to make her stop, and she screamed at me for about ten minutes.

If any of these drugs touch me, I will die. Period, end of discussion. I will die. I cannot pick up a pill to give to my cat without wearing gloves. I'll just have to hope that my cockroach-like immune system can keep me safe until some alternative treatments come along.

Yes, it is true that not taking the full course of antibiotics can lead to increased drug resistance. This is because when you start to feel better, you still might have a reasonably high concentration of bacteria in your body. Not enough to make you feel sick, but you haven't killed them off. If you stop taking the antibiotics, then these bacteria can multiply over many generations and the few strains of them that are somewhat tolerant of the anti-biotic will continue to multiply and evolve even more resistance. Taking the full course will not kill all the bacteria that caused the initial infection, but the goal is to get their population to such low numbers that they would have a much more difficult time continuing to multiply in large colonies that have a higher change of developing drug resistance.

I've read some research that shows that this is a particularly problem in some developing nations where anti-biotics are often available on the black market without a doctor's prescription. This is bad for everyone, b/c bacteria know no borders. This isn't to say that there isn't rampant abuse of antibiotics in more industrialized nations either. Doctor's are often quick to prescribe them to demanding patients...and patients often don't comply with instructions.

Antibiotics can also cause other side effects like fungal infections by changing pH levels or digestive problems by killing the necessary bacteria in your intestinal tract. They have indeed saved many lives, but that doesn't mean they should be used as a cure all for whatever ails.