Resistance against antimicrobial drugs is one of the major challenges to 21st century
medicine. There are two ways to fight resistance evolution. First, discover and
deploy new drugs. Second, use drugs wisely, for example in combination therapy.
Such wise-use strategies are among humanitys largest efforts to intentionally
manage the evolution of any organism. A resistance management strategy widely
advocated by professional bodies, medical schools and public health authorities is to
ensure very high cure rates through full adherence to correct dosing regimens. I will
propose that this resistance management strategy may be promoting the very
evolution it is designed to retard. There is a need for evidence-based resistance
management strategies, and I will discuss how these might be developed.