It's probably the patients fault that there is a opioid crisis and a ton of useless people who trot on out of their car after parking in a handicap spot. I wish they'd stop letting patients write prescriptions for themselves.
From USA National Library of Medicine.
Inappropriate Prescribing
Incorrectly prescribed antibiotics also contribute to the promotion of resistant bacteria.5 Studies have shown that treatment indication, choice of agent, or duration of antibiotic therapy is incorrect in 30% to 50% of cases.
Incorrectly prescribed antibiotics have questionable therapeutic benefit and expose patients to potential complications of antibiotic therapy.11 Subinhibitory and subtherapeutic antibiotic concentrations can promote the development of antibiotic resistance by supporting genetic alterations, such as changes in gene expression, HGT, and mutagenesis.8 Changes in antibiotic-induced gene expression can increase virulence, while increased mutagenesis and HGT promote antibiotic resistance and spread.8 Low levels of antibiotics have been shown to contribute to strain diversification in organisms such as Pseudomonas aeruginosa.8 Subinhibitory concentrations of piperacillin and/or tazobactam have also been shown to induce broad proteomic alterations in Bacteroides fragilis.8
Extensive Agricultural Use
In both the developed and developing world, antibiotics are widely used as growth supplements in livestock.5,10,14 An estimated 80% of antibiotics sold in the U.S. are used in animals, primarily to promote growth and to prevent infection.7,12,14 Treating livestock with antimicrobials is said to improve the overall health of the animals, producing larger yields and a higher-quality product.15
The antibiotics used in livestock are ingested by humans when they consume food.1 The transfer of resistant bacteria to humans by farm animals was first noted more than 35 years ago, when high rates of antibiotic resistance were found in the intestinal flora of both farm animals and farmers.14 More recently, molecular detection methods have demonstrated that resistant bacteria in farm animals reach consumers through meat products.14 This occurs through the following sequence of events: 1) antibiotic use in food-producing animals kills or suppresses susceptible bacteria, allowing antibiotic-resistant bacteria to thrive; 2) resistant bacteria are transmitted to humans through the food supply; 3) these bacteria can cause infections in humans that may lead to adverse health consequences.5
The agricultural use of antibiotics also affects the environmental microbiome.5,14 Up to 90% of the antibiotics given to livestock are excreted in urine and stool, then widely dispersed through fertilizer, groundwater, and surface runoff.5,14 In addition, tetracyclines and streptomycin are sprayed on fruit trees to act as pesticides in the western and southern U.S.1 While this application accounts for a much smaller proportion of overall antibiotic use, the resultant geographical spread can be considerable.1 This practice also contributes to the exposure of microorganisms in the environment to growth-inhibiting agents, altering the environmental ecology by increasing the proportion of resistant versus susceptible microorganisms.1
Antibacterial products sold for hygienic or cleaning purposes may also contribute to this problem, since they may limit the development of immunities to environmental antigens in both children and adults.
