Evolving antibacterial therapies

On Slate, Brian Palmer says we need better tactics, not better antibiotics, to combat drug-resistant bacteria. But the new “tactics” he describes are, basically, new drugs:

In vitro studies have shown that chemicals like ascorbic acid shut down the movement of antibiotic resistance between cells. (Right now it’s effective only at concentrations that a person couldn’t tolerate, but it’s a start.) Because almost all antibiotic resistance relies on genetic transfer, this technique might be the solution we’ve been seeking since the very first colony of bacteria solved penicillin in 1944.

Drugs that combat gene transfer between bacteria probably would slow the spread of new antibiotic-resistance genes. Until bacteria evolve ways to transfer genes in spite of anti-transfer drugs, that is.

A genuinely new approach to circumvent antibiotic resistance will require actually thinking about the evolutionary consequences of therapy — and creating natural selection that eliminates the damage done by bacteria without also creating a fitness advantage for resistance to the therapy. That’s tricky, to say the least, but it’s not impossible. Such an approach has been outlined to control disease-carrying mosquitoes, for instance.