Are_VBR We_PPIS2 Running_VVG Out_II21 of_II22 Antibiotics_NN2 ?_? 
Hardly_RR any_DD doctors_NN2 still_RR practicing_VVG can_VM remember_VVI life_NN1 before_II antibiotics_NN2 ,_, when_RRQ people_NN were_VBDR routinely_RR hospitalized_VVN for_IF common_JJ infections_NN2 ,_, and_CC the_AT threat_NN1 of_IO deadly_JJ Staphylococcus_NN1 shadowed_VVD even_RR the_AT simplest_JJT surgery_NN1 ._. 
But_CCB infectious-disease_JJ specialists_NN2 like_II Brad_NP1 Spellberg_NP1 of_IO UCLA_NP1 's_GE David_NP1 Geffen_NP1 School_NN1 of_IO Medicine_NN1 have_VH0 been_VBN reading_VVG up_RP on_II those_DD2 days_NNT2 because_II21 of_II22 a_AT1 growing_JJ fear_NN1 they_PPHS2 are_VBR not_XX all_DB in_II the_AT past_NN1 ._. 
Wealthy_JJ countries_NN2 take_VV0 for_IF granted_VVN the_AT triumph_NN1 of_IO science_NN1 over_II bacteria_NN2 ,_, but_CCB increasingly_RR doctors_NN2 are_VBR coming_VVG up_RP against_II infections_NN2 that_CST can_VM be_VBI quelled_VVN only_RR by_II the_AT most_RGT powerful_JJ antibiotics_NN2 known_VVN to_II medicine_NN1 --_NN1 or_CC by_II none_PN of_IO them_PPHO2 ._. 
"_" It_PPH1 's_VBZ already_RR happening_VVG ,_, "_" says_VVZ Spellberg_NP1 ,_, to_II the_AT tune_NN1 of_IO roughly_RR 100,000_MC deaths_NN2 a_AT1 year_NNT1 from_II antibiotic-resistant_JJ infections_NN2 in_II the_AT United_NP1 States_NP1 alone_RR ._. 
"_" But_CCB it_PPH1 's_VBZ going_VVGK to_TO become_VVI much_DA1 more_DAR common_JJ ._. "_" 
Imagine_VV0 a_AT1 world_NN1 in_II which_DDQ antibiotics_NN2 resemble_VV0 chemotherapy_NN1 drugs_NN2 and_CC you_PPY can_VM understand_VVI what_DDQ keeps_VVZ Spellberg_NP1 awake_JJ at_II night_NNT1 ._. 
In_II the_AT future_NN1 ,_, historians_NN2 of_IO science_NN1 may_VM debate_VVI whether_CSW victory_NN1 over_II bacteria_NN2 was_VBDZ ever_RR within_II our_APPGE grasp_NN1 ._. 
But_CCB it_PPH1 seems_VVZ almost_RR certain_JJ that_CST the_AT 60_MC or_CC so_RR years_NNT2 after_II penicillin_NN1 came_VVD to_TO market_VVI will_VM eventually_RR be_VBI viewed_VVN as_CSA just_RR an_AT1 interlude_NN1 in_II the_AT eternal_JJ war_NN1 between_II us_PPIO2 and_CC them_PPHO2 ._. 
We_PPIS2 are_VBR multicelled_JJ animals_NN2 of_IO astonishing_JJ complexity_NN1 and_CC delicacy_NN1 ,_, moving_VVG through_II a_AT1 world_NN1 in_II which_DDQ they_PPHS2 vastly_RR outnumber_VV0 us_PPIO2 ._. 
They_PPHS2 are_VBR single-celled_JJ organisms_NN2 so_RG primitive_JJ they_PPHS2 lack_VV0 even_RR a_AT1 nucleus_NN1 ,_, marvelously_RR adapted_VVN to_TO multiply_VVI inside_II us_PPIO2 ,_, cell_NN1 membranes_NN2 that_CST wo_VM n't_XX let_VVI them_PPHO2 in_RP ,_, tiny_JJ pumps_NN2 that_CST push_VV0 them_PPHO2 back_RP out_RP ,_, biochemical_JJ tweaks_NN2 that_CST make_VV0 them_PPHO2 harmless_JJ ._. 
Evolution_NN1 is_VBZ a_AT1 process_NN1 that_CST has_VHZ been_VBN at_II work_NN1 on_II earth_NN1 for_IF hundreds_NNO2 of_IO millions_NNO2 of_IO years_NNT2 ;_; modern_JJ biological_JJ science_NN1 has_VHZ been_VBN around_RP for_IF less_DAR than_CSN a_AT1 century_NNT1 and_CC a_AT1 half_NN1 ._. 
Which_DDQ would_VM you_PPY bet_VVI on_RP ?_? 
We_PPIS2 have_VH0 handicapped_VVN ourselves_PPX2 in_II this_DD1 race_NN1 ,_, partly_RR through_II carelessness_NN1 and_CC partly_RR as_II an_AT1 outcome_NN1 of_IO the_AT complex_JJ politics_NN1 and_CC economics_NN1 of_IO drug_NN1 policy_NN1 ._. 
We_PPIS2 've_VH0 squandered_VVN our_APPGE antibiotics_NN2 through_II overuse_NN1 and_CC ,_, paradoxically_RR ,_, by_II under-use_NN1 ._. 
Particularly_RR among_II the_AT poor_JJ and_CC illiterate_JJ ,_, it_PPH1 's_VBZ not_XX uncommon_JJ for_IF patients_NN2 to_TO stop_VVI taking_VVG antibiotics_NN2 as_CS31 soon_CS32 as_CS33 they_PPHS2 feel_VV0 better_JJR --_NN1 leaving_VVG behind_II a_AT1 residual_JJ population_NN1 of_IO resistant_JJ bacteria_NN2 to_TO multiply_VVI and_CC spread_NN1 ._. 
For_IF a_AT1 while_NNT1 this_DD1 did_VDD n't_XX matter_VVI ,_, because_CS there_EX were_VBDR always_RR new_JJ antibiotics_NN2 being_VBG discovered_VVN ._. 
Beginning_VVG in_II the_AT 1940s_MC2 ,_, when_CS penicillin_NN1 first_MD hit_NN1 pharmacy_NN1 shelves_NN2 ,_, humanity_NN1 embarked_VVN on_II a_AT1 decades-long_JJ quest_NN1 to_TO collect_VVI as_RG many_DA2 soil_NN1 samples_NN2 as_CSA possible_JJ and_CC probe_VV0 them_PPHO2 for_IF potential_JJ miracle_NN1 cures_NN2 ._. 
Allied_JJ soldiers_NN2 scooped_VVD up_RP dirt_NN1 from_II the_AT African_JJ front_NN1 ,_, the_AT National_JJ Geographic_JJ Society_NN1 collected_VVD samples_NN2 from_II the_AT top_NN1 of_IO the_AT Himalayas_NP2 ,_, and_CC schoolchildren_NN2 everywhere_RL dug_VVD up_RP shovelfuls_NN2 from_II parks_NN2 and_CC fields_NN2 ._. 
Pharmaceutical_JJ companies_NN2 led_VVD the_AT charge_NN1 in_II harvesting_VVG this_DD1 vast_JJ collection_NN1 ,_, ultimately_RR producing_VVG some_DD 200_MC new_JJ drugs_NN2 in_II a_AT1 mere_JJ three_MC decades_NNT2 ._. 
But_CCB by_II the_AT mid-1980s_NN2 ,_, the_AT discoveries_NN2 had_VHD slowed_VVN to_II a_AT1 trickle_NN1 ._. 
"_" It_PPH1 's_VBZ a_RR21 bit_RR22 like_II oil_NN1 ,_, "_" says_VVZ Spellberg_NP1 ,_, author_NN1 of_IO the_AT book_NN1 Rising_VVG Plague_NN1 ._. 
"_" There_EX 's_VBZ still_RR a_RR21 lot_RR22 out_RP there_RL ,_, but_CCB we_PPIS2 've_VH0 harvested_VVN all_DB the_AT easy_JJ gets_VVZ ._. 
There_EX are_VBR very_RG few_DA2 places_NN2 left_VVN where_CS you_PPY can_VM just_RR tap_VVI the_AT ground_NN1 and_CC find_VVI some_DD bountiful_JJ reserve_NN1 ._. "_" 
For_IF a_AT1 time_NNT1 ,_, scientists_NN2 thought_VVD the_AT molecular_JJ wizardry_NN1 of_IO modern_JJ drug_NN1 design_NN1 --_JJ small_JJ molecules_NN2 ,_, high_JJ throughput_NN1 screening_NN1 ,_, and_CC the_AT like_JJ --_NN1 might_VM reinvigorate_VVI our_APPGE war_NN1 against_II bacteria_NN2 ,_, the_AT same_DA way_NN1 it_PPH1 reinvigorated_VVD our_APPGE war_NN1 against_II cancer_NN1 ._. 
No_AT such_DA luck_NN1 ._. 
"_" There_EX are_VBR a_AT1 set_NN1 of_IO rules_NN2 that_CST chemists_NN2 follow_VV0 when_CS looking_VVG for_IF new_JJ drugs_NN2 ,_, "_" says_VVZ AstraZeneca_NP1 medical_JJ director_NN1 John_NP1 Rex_NP1 ._. 
"_" To_TO make_VVI an_AT1 antibiotic_NN1 ,_, you_PPY have_VH0 to_TO break_VVI those_DD2 rules_NN2 ._. 
They_PPHS2 are_VBR different_JJ from_II anything_PN1 else_RR we_PPIS2 make_VV0 because_CS they_PPHS2 are_VBR designed_VVN to_TO kill_VVI a_AT1 living_JJ organism_NN1 inside_II another_DD1 living_JJ organism_NN1 ._. "_" 
That_DD1 is_VBZ not_XX to_TO say_VVI that_CST there_EX are_VBR no_AT more_RGR wonder_JJ drugs_NN2 left_VVD to_TO find_VVI ._. 
Indeed_RR ,_, oceanographers_NN2 have_VH0 turned_VVN up_RP hundreds_NNO2 of_IO thousands_NNO2 of_IO previously_RR unknown_JJ organisms_NN2 in_II a_AT1 single_JJ cubic_JJ centimeter_NN1 of_IO deep-sea_JJ mud_NN1 ._. 
Bacteriophages_VVZ --_JJ viruses_NN2 that_CST infect_VV0 and_CC kill_VV0 bacteria_NN2 --_NN1 remain_VV0 a_AT1 vast_JJ untapped_JJ source_NN1 of_IO potential_JJ anti-microbial_JJ medications_NN2 ,_, and_CC the_AT same_DA soils_NN2 that_CST gave_VVD us_PPIO2 some_DD of_IO the_AT first_MD and_CC most_RGT successful_JJ antibiotics_NN2 ._. 
But_CCB the_AT researchers_NN2 '_GE best_RRT equipped_VVN to_TO do_VDI that_DD1 examining_VVG have_VH0 long_RR since_CS abandoned_VVN antibiotics_NN2 ._. 
According_II21 to_II22 the_AT Infectious_JJ Disease_NN1 Society_NN1 of_IO America_NP1 ,_, only_RR five_MC of_IO the_AT 13_MC biggest_JJT pharmaceutical_JJ companies_NN2 are_VBR still_RR looking_VVG at_RR21 all_RR22 ._. 
Medications_NN2 that_CST treat_VV0 cancer_NN1 or_CC chronic_JJ conditions_NN2 like_II diabetes_NN1 ,_, heart_NN1 disease_NN1 ,_, or_CC even_RR baldness_NN1 are_VBR simply_RR much_RR more_RGR lucrative_JJ ._. 
That_DD1 's_VBZ because_CS a_AT1 single_JJ course_NN1 of_IO the_AT most_RGT expensive_JJ antibiotics_NN2 (_( linezolid_NN1 and_CC daptomycin_NN1 )_) runs_VVZ just_RR seven_MC days_NNT2 and_CC sells_VVZ for_IF $1,000_NNU to_II $2,000_NNU ,_, while_CS a_AT1 single_JJ course_NN1 of_IO ,_, say_VV0 ,_, any_DD given_JJ cancer_NN1 treatment_NN1 runs_VVZ for_IF weeks_NNT2 to_II months_NNT2 and_CC costs_VVZ from_II 10_MC to_II 20_MC times_NNT2 as_RG much_DA1 ._. 
Chronic-disease_JJ medications_NN2 ,_, which_DDQ a_AT1 patient_NN1 typically_RR takes_VVZ for_IF the_AT rest_NN1 of_IO his_APPGE or_CC her_APPGE life_NN1 ,_, yield_VV0 even_RR higher_JJR returns_NN2 ._. 
It_PPH1 does_VDZ n't_XX matter_VVI that_DD1 bacterial_JJ infections_NN2 are_VBR infinitely_RR more_RGR common_JJ than_CSN cancer_NN1 or_CC even_RR heart_NN1 disease_NN1 ;_; antibiotics_NN2 are_VBR still_RR less_RGR profitable_JJ ,_, in_RR21 part_RR22 because_CS we_PPIS2 undervalue_VV0 them_PPHO2 ._. 
"_" We_PPIS2 expect_VV0 antibiotics_NN2 to_TO be_VBI not_XX only_RR safe_JJ and_CC highly_RR effective_JJ ,_, but_CCB cheap_JJ too_RR ,_, "_" says_VVZ Princeton_NP1 University_NN1 health_NN1 economist_NN1 Ramanan_NN1 Laxminarayan_NN1 ._. 
"_" We_PPIS2 see_VV0 them_PPHO2 as_CSA like_II a_AT1 God-given_JJ right_NN1 ._. "_" 
Case_NN1 in_II point_NN1 :_: in_II 2009_MC several_DA2 large_JJ chain_NN1 pharmacies_NN2 began_VVD giving_VVG away_RL free_JJ generic_JJ antibiotics_NN2 in_II an_AT1 effort_NN1 to_TO lure_VVI more_DAR customers_NN2 ._. 
Even_RR when_CS an_AT1 antibiotic_NN1 is_VBZ highly_RR prized_VVN ,_, the_AT twin_NN1 forces_NN2 of_IO drug_NN1 resistance_NN1 and_CC patent_NN1 law_NN1 still_RR conspire_VV0 against_II it_PPH1 in_II the_AT marketplace_NN1 ._. 
To_TO prevent_VVI resistance_NN1 from_II developing_VVG ,_, doctors_NN2 are_VBR encouraged_VVN to_TO conserve_VVI the_AT newest_JJT ,_, most_RGT powerful_JJ antibiotics_NN2 ,_, using_VVG them_PPHO2 only_RR in_II the_AT direst_JJT of_IO circumstances_NN2 ._. 
While_CS this_DD1 preserves_VVZ the_AT drug_NN1 's_GE value_NN1 as_II a_AT1 treatment_NN1 option_NN1 ,_, it_PPH1 also_RR means_VVZ that_CST sales_NN will_VM be_VBI slowest_JJT when_CS a_AT1 compound_NN1 is_VBZ new_JJ ,_, and_CC will_VM pick_VVI up_RP only_RR toward_II the_AT end_NN1 of_IO its_APPGE patent_NN1 life_NN1 ,_, when_CS it_PPH1 can_VM easily_RR be_VBI supplanted_VVN by_II cheaper_JJR generic_JJ brands_NN2 ._. 
"_" It_PPH1 's_VBZ a_AT1 huge_JJ disincentive_NN1 to_TO develop_VVI anything_PN1 new_JJ ,_, "_" says_VVZ Rex_NP1 ,_, whose_DDQGE company_NN1 is_VBZ one_MC1 of_IO the_AT few_DA2 still_RR developing_VVG new_JJ antibiotics_NN2 ._. 
Of_RR21 course_RR22 ,_, those_DD2 economic_JJ conundrums_NN2 pale_JJ in_II comparison_NN1 to_II the_AT unique_JJ regulatory_JJ uncertainty_NN1 that_CST antibiotics_NN2 face_VV0 ._. 
To_TO test_VVI any_DD compound_NN1 against_II any_DD infection_NN1 ,_, one_MC1 first_MD needs_VVZ to_TO find_VVI a_AT1 group_NN1 of_IO patients_NN2 ._. 
This_DD1 is_VBZ easy_RR enough_RR for_IF cancer_NN1 or_CC chronic_JJ diseases_NN2 ,_, or_CC any_DD fatal_JJ condition_NN1 where_CS prospective_JJ study_NN1 participants_NN2 have_VH0 some_DD time_NNT1 to_TO consider_VVI their_APPGE options_NN2 ._. 
It_PPH1 's_VBZ a_RR21 bit_RR22 trickier_JJR with_IW infectious_JJ diseases_NN2 ,_, especially_RR those_DD2 that_CST are_VBR drug-resistant_JJ ._. 
"_" You_PPY pretty_RG much_DA1 need_NN1 to_TO wait_VVI for_IF an_AT1 outbreak_NN1 to_TO occur_VVI ,_, "_" Rex_NP1 says_VVZ ._. 
Only_RR three_MC patients_NN2 enrolled_VVN in_II the_AT study_NN1 ._. 
A_AT1 second_MD attempt_NN1 secured_VVD just_RR 45_MC patients_NN2 in_II 18_MC months_NNT2 ,_, thanks_NN2 largely_RR to_II an_AT1 outbreak_NN1 at_II one_MC1 testing_NN1 site_NN1 ._. 
Both_DB2 studies_NN2 were_VBDR closed_VVN due_II21 to_II22 insufficient_JJ enrollment_NN1 ._. 
Five_MC years_NNT2 later_RRR ,_, the_AT drug_NN1 remains_VVZ stuck_VVN in_II clinical-trial_JJ limbo_NN1 ._. 
That_DD1 is_VBZ not_XX to_TO say_VVI that_DD1 VRE_NN1 is_VBZ n't_XX a_AT1 significant_JJ problem_NN1 ._. 
According_II21 to_II22 the_AT Centers_NN2 for_IF Disease_NN1 Control_NN1 and_CC Prevention_NN1 ,_, this_DD1 particular_JJ super-bug_NN1 infects_VVZ some_DD 26,000_MC hospital_NN1 patients_NN2 each_DD1 year_NNT1 ._. 
But_CCB so_RG far_RR ,_, no_PN121 one_PN122 has_VHZ a_AT1 good_JJ way_NN1 to_TO match_VVI those_DD2 patients_NN2 to_II trials_NN2 ._. 
When_RRQ drugmakers_NN2 do_VD0 manage_VVI to_TO cobble_VVI together_RL a_AT1 decent-size_JJ group_NN1 of_IO study_NN1 participants_NN2 ,_, they_PPHS2 need_VV0 to_TO test_VVI their_APPGE prospective_JJ drug_NN1 against_II a_AT1 proven_JJ medication_NN1 ._. 
If_CS the_AT experimental_JJ drug_NN1 is_VBZ as_RG good_JJ as_CSA or_CC better_RRR than_CSN the_AT existing_JJ treatment_NN1 ,_, it_PPH1 gets_VVZ a_AT1 green_JJ light_NN1 ._. 
Sounds_VVZ simple_JJ ,_, but_CCB it_PPH1 is_VBZ n't_XX ._. 
The_AT problem_NN1 is_VBZ that_CST many_DA2 antibiotics_NN2 were_VBDR tested_VVN and_CC approved_VVN before_CS there_EX was_VBDZ any_DD such_DA thing_NN1 as_CSA the_AT FDA_NN1 or_CC double-blind_JJ placebo-controlled_JJ clinical_JJ trials_NN2 ._. 
And_CC that_DD1 has_VHZ left_VVN clinicians_NN2 and_CC statisticians_NN2 at_II odds_NN2 over_II how_RRQ to_TO measure_VVI success_NN1 ._. 
"_" The_AT clinical_JJ evidence_NN1 that_CST has_VHZ guided_VVN antibiotic_NN1 therapy_NN1 for_IF decades_NNT2 means_VVZ nothing_PN1 to_II the_AT statisticians_NN2 ,_, "_" says_VVZ Paul_NP1 Ambrose_NP1 ,_, president_NN1 of_IO the_AT Institute_NN1 for_IF Clinical_JJ Pharmacodynamics_NN2 in_II New_NP1 York_NP1 ._. 
"_" This_DD1 is_VBZ part_NN1 of_IO a_AT1 larger_JJR FDA-wide_JJ crisis_NN1 over_II how_RRQ to_TO measure_VVI drug_NN1 effectiveness_NN1 ._. 
But_CCB antibiotics_NN2 have_VH0 it_PPH1 the_AT worst_JJT because_CS they_PPHS2 have_VH0 no_AT placebo-controlled_JJ data_NN to_TO begin_VVI with_IW ._. "_" 
For_IF just_RR one_MC1 example_NN1 of_IO how_RGQ sticky_JJ this_DD1 can_VM get_VVI ,_, take_VV0 skin_NN1 infections_NN2 ._. 
Last_MD year_NNT1 the_AT FDA_NP1 issued_VVD guidelines_NN2 for_IF companies_NN2 seeking_VVG to_TO develop_VVI new_JJ antibiotics_NN2 to_TO treat_VVI this_DD1 condition_NN1 ._. 
It_PPH1 's_VBZ definition_NN1 of_IO a_AT1 successful_JJ drug_NN1 ?_? 
One_PN1 that_CST stopped_VVD skin_NN1 lesions_NN2 from_II spreading_NN1 ,_, even_CS21 if_CS22 it_PPH1 did_VDD n't_XX make_VVI the_AT lesions_NN2 disappear_VVI ._. 
"_" So_RR if_CS you_PPY come_VV0 to_II me_PPIO1 with_IW skin_NN1 lesions_NN2 ,_, and_CC I_PPIS1 give_VV0 you_PPY a_AT1 drug_NN1 ,_, and_CC in_II three_MC days_NNT2 the_AT lesions_NN2 are_VBR exactly_RR the_AT same_DA ,_, that_DD1 counts_VVZ as_CSA a_AT1 success_NN1 ,_, "_" Ambrose_NP1 explains_VVZ ._. 
"_" How_RRQ did_VDD they_PPHS2 come_VVI up_RP with_IW this_DD1 ?_? "_" 
It_PPH1 turns_VVZ out_RP that_CST the_AT FDA_NN1 based_VVN its_APPGE proposed_JJ rules_NN2 on_II just_RR two_MC studies_NN2 ,_, both_RR published_VVN in_II 1937_MC ,_, which_DDQ compared_VVD an_AT1 antibiotic_NN1 to_II UV-lamp_JJ therapy_NN1 ._. 
The_AT UV_JJ therapy_NN1 was_VBDZ so_RG ineffective_JJ that_CST investigators_NN2 were_VBDR thrilled_VVN just_RR to_TO have_VHI patients_NN2 not_XX get_VV0 worse_JJR ._. 
So_RR they_PPHS2 counted_VVD that_CST as_II a_AT1 success_NN1 ._. 
The_AT FDA_NN1 has_VHZ spent_VVN the_AT past_JJ year_NNT1 working_VVG with_IW would-be_JJ antibiotic_NN1 manufacturers_NN2 to_TO develop_VVI a_AT1 clear_JJ path_NN1 around_II such_DA issues_NN2 ,_, but_CCB critics_NN2 say_VV0 that_CST in_II that_DD1 time_NNT1 ,_, the_AT level_NN1 of_IO uncertainty_NN1 has_VHZ only_RR increased_VVN ._. 
"_" There_EX are_VBR viable_JJ solutions_NN2 ,_, but_CCB we_PPIS2 need_VV0 fresh_JJ voices_NN2 ,_, "_" Ambrose_NP1 says_VVZ ._. 
"_" It_PPH1 's_VBZ one_MC1 or_CC two_MC statisticians_NN2 ,_, and_CC a_AT1 handful_NN1 of_IO clinicians_NN2 arguing_VVG back_RP and_CC forth_RR and_CC back_RP again_RT over_II the_AT same_DA few_DA2 points_NN2 ._. "_" 
In_II the_AT meantime_NNT1 ,_, without_IW clear_JJ guidance_NN1 on_II how_RRQ to_TO get_VVI new_JJ antibiotics_NN2 approved_VVN ,_, pharmaceutical_JJ companies_NN2 are_VBR n't_XX going_VVGK to_TO invest_VVI the_AT money_NN1 to_TO find_VVI and_CC develop_VVI them_PPHO2 ._. 
Neither_RR ,_, it_PPH1 seems_VVZ ,_, is_VBZ anyone_PN1 else_RR ._. 
In_II 2009_MC the_AT National_JJ Institute_NN1 of_IO Allergy_NP1 and_CC Infectious_JJ Diseases_NN2 spent_VVD $94_NNU million_NNO on_II research_NN1 into_II treatments_NN2 for_IF potential_NN1 ,_, albeit_CS exceedingly_RR rare_JJ ,_, bioterrorism_NN1 agents_NN2 like_II anthrax_NN1 and_CC plague_NN1 ,_, and_CC only_RR $16_NNU million_NNO on_II developing_VVG new_JJ medications_NN2 to_TO treat_VVI drug-resistant_JJ pathogens_NN2 ._. 
Likewise_RR ,_, Project_NP1 Bioshield_NP1 ,_, enacted_VVN after_II the_AT 2001_MC anthrax_NN1 attacks_NN2 ,_, spurred_VVD volumes_NN2 of_IO research_NN1 on_II the_AT most_RGT worrisome_JJ bioterrorism_NN1 agents_NN2 ._. 
By_II promising_JJ to_TO purchase_VVI any_DD successful_JJ products_NN2 ,_, the_AT federal_JJ government_NN1 ensured_VVD that_CST drugs_NN2 to_TO treat_VVI anthrax_NN1 ,_, plague_NN1 ,_, and_CC Ebola_NP1 would_VM be_VBI profitable_JJ ,_, despite_II the_AT rarity_NN1 of_IO those_DD2 conditions_NN2 ._. 
But_CCB that_DD1 legislation_NN1 included_VVD no_AT such_DA guarantee_NN1 for_IF antibiotics_NN2 to_TO treat_VVI much_DA1 more_DAR common_JJ drug-resistant_JJ infections_NN2 ._. 
An_AT1 analogous_JJ plan_NN1 to_TO combat_VVI antimicrobial_JJ resistance_NN1 was_VBDZ launched_VVN around_II the_AT same_DA time_NNT1 ,_, but_CCB critics_NN2 say_VV0 that_CST it_PPH1 was_VBDZ grossly_RR underfunded_JJ and_CC thus_RR never_RR quite_RR put_VVN into_II action_NN1 ._. 
Policymakers_NN2 are_VBR ,_, at_RR21 last_RR22 ,_, working_VVG to_TO change_VVI this_DD1 ._. 
One_MC1 bill_NN1 floating_VVG through_II Congress_NN1 ,_, the_AT Generating_JJ Antibiotic_NN1 Incentives_NN2 Now_RT Act_VV0 ,_, would_VM extend_VVI the_AT patents_NN2 on_II certain_JJ types_NN2 of_IO antibiotics_NN2 by_II five_MC years_NNT2 to_TO protect_VVI them_PPHO2 from_II generic_JJ competition_NN1 ._. 
Other_JJ proposals_NN2 include_VV0 tax_NN1 breaks_NN2 ,_, liability_NN1 protection_NN1 ,_, and_CC the_AT same_DA guaranteed_JJ government_NN1 purchases_VVZ that_CST have_VH0 been_VBN so_RG successful_JJ in_II spurring_VVG bioterrorism_NN1 research_NN1 ._. 
Of_RR21 course_RR22 ,_, as_CSA critics_NN2 point_VV0 out_RP ,_, market-based_JJ incentives_NN2 are_VBR no_AT substitute_NN1 for_IF more_RGR judicious_JJ use_NN1 of_IO existing_JJ antibiotics_NN2 ._. 
"_" Its_APPGE like_JJ saying_NN1 ,_, 'we_VV0 're_VBR running_VVG out_II21 of_II22 oil_NN1 because_CS we_PPIS2 are_VBR doing_VDG a_AT1 terrible_JJ job_NN1 at_II conserving_VVG it_PPH1 ,_, and_CC the_AT only_JJ solution_NN1 is_VBZ to_TO find_VVI more_DAR oil_NN1 ,_, '_" ?_? "_" says_VVZ Laxminarayan_NN1 ._. 
"_" If_CS we_PPIS2 just_RR keep_VV0 developing_JJ new_JJ drugs_NN2 ,_, and_CC then_RT overusing_VVG them_PPHO2 ,_, we_PPIS2 are_VBR n't_XX going_VVGK to_TO solve_VVI anything_PN1 ._. "_" 
The_AT trick_NN1 ,_, he_PPHS1 says_VVZ ,_, is_VBZ to_TO start_VVI talking_VVG about_II antibiotics_NN2 in_II the_AT same_DA terms_NN2 that_CST we_PPIS2 use_VV0 to_TO discuss_VVI other_JJ nonrenewable_JJ natural_JJ resources_NN2 --_NN1 namely_REX ,_, conservation_JJ and_CC sustainable_JJ use_NN1 ._. 
That_DD1 would_VM certainly_RR mark_VVI a_AT1 paradigm_NN1 shift_NN1 ._. 
The_AT CDC_NP1 estimates_VVZ that_CST as_RG much_DA1 as_CSA 50_MC percent_NNU of_IO all_DB antibiotic_NN1 use_NN1 is_VBZ unnecessary_JJ ._. 
Doctors_NN2 routinely_RR prescribe_VV0 antibiotics_NN2 as_II a_AT1 precautionary_JJ measure_NN1 ,_, to_II ward_NN1 off_II infections_NN2 that_CST have_VH0 not_XX yet_RR occurred_VVN ,_, or_CC to_TO appease_VVI patients_NN2 worried_VVN about_II falling_VVG ill_JJ while_NNT1 on_II the_AT road_NN1 ._. 
And_CC for_IF patients_NN2 who_PNQS are_VBR infected_VVN ,_, the_AT approach_NN1 is_VBZ hardly_RR more_RGR sophisticated_JJ ._. 
Most_DAT diagnostic_JJ methods_NN2 pre-date_VV0 penicillin_NN1 ,_, which_DDQ is_VBZ to_TO say_VVI they_PPHS2 are_VBR slow_JJ ,_, cumbersome_JJ ,_, and_CC unreliable_JJ ._. 
This_DD1 means_VVZ doctors_NN2 often_RR have_VH0 no_AT way_NN1 of_IO knowing_VVG which_DDQ bug_VV0 a_AT1 patient_NN1 is_VBZ infected_VVN with_IW ,_, or_CC which_DDQ drugs_NN2 that_CST bug_NN1 might_VM be_VBI susceptible_JJ to_TO ._. 
Rather_CS21 than_CS22 waste_VVI time_NNT1 and_CC money_NN1 trying_VVG to_TO answer_VVI those_DD2 basic_JJ questions_NN2 ,_, they_PPHS2 often_RR prescribe_VV0 a_AT1 couple_NN1 of_IO antibiotics_NN2 at_RR21 once_RR22 and_CC then_RT just_RR cross_VV0 their_APPGE fingers_NN2 ._. 
This_DD1 approach_NN1 is_VBZ cheaper_JJR ,_, and_CC in_II the_AT short_JJ term_NN1 it_PPH1 works_VVZ ,_, but_CCB it_PPH1 also_RR contributes_VVZ to_TO overuse_VVI and_CC thus_RR allows_VVZ resistance_NN1 to_TO grow_VVI and_CC spread_NN1 ._. 
The_AT future_NN1 will_VM almost_RR certainly_RR be_VBI different_JJ ._. 
Antibiotics_NN2 will_VM cost_VVI more_DAR and_CC do_VD0 less_DAR ._. 
They_PPHS2 will_VM also_RR be_VBI less_RGR readily_RR available_JJ than_CSN we_PPIS2 are_VBR accustomed_VVN to_II ._. 
No_AT more_RGR fast_JJ cures_NN2 ,_, free_JJ giveaways_NN2 ,_, or_CC "_" just_RR in_CS21 case_CS22 "_" prescriptions_NN2 ._. 
But_CCB if_CS we_PPIS2 act_VV0 quickly_RR --_JJ and_CC if_CS we_PPIS2 're_VBR lucky_JJ --_NN1 it_PPH1 's_VBZ still_RR possible_JJ that_CST we_PPIS2 wo_VM n't_XX have_VHI to_TO know_VVI a_AT1 world_NN1 without_IW them_PPHO2 ._. 
