Arney,

Yes, your explanation supports my theory that social/medical protocol practices are in part responsible for the reduction/prevention of MRSA in entering the Dutch Hospital environment. As you state, many other European countries have higher rates then Holland. This, in part is not necessarily due to the restrictive use of antibiotics, but the thoughtful identification and isolation of patients with MRSA.

Once an organism develops antibiotic resistance, the best way to deal with control (not on an individual basis but the population as a whole), is not necessarily developing additional drugs to which the organism is sensitive, but to institute practices to prevent spread.

As you know, one main problem with the development of antibiotic resistant organisms is not only over prescribing and inappropriate treatment (giving antibiotics for viral infections), but incomplete or inappropriate treatment regimes by a patient’s actions. Many will discontinue to take a full course of antibiotics because they either “feel better’ or are unable to afford a complete course of treatment. Many also fail to take the meds at the proper time; ensuring therapeutic thresholds are maintained or are they are taken inappropriately (sometimes with meals sometimes without or with drugs/supplements that inactivate the drug).

Many of these factors are social-economically based. Populations, who are not given the proper education or for whatever reason do not follow proper treatment regimes or demand treatment when no treatment is appropriate, are just as guilty as the medical community for the development of antibiotic resistant organisms.

Pete