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Every time a course of antibiotics is prescribed by a GP surgery or an NHS hospital, it puts a bacterial population under intense selection pressure. Most bacteria in an infection are killed by the drug, but a tiny number may already carry a random mutation that happens to protect them, for example by breaking down the antibiotic molecule before it can act. These resistant bacteria survive, face far less competition for space and nutrients, and reproduce rapidly by binary fission, doubling in number every twenty minutes or so under favourable conditions. Because bacteria reproduce so quickly, resistant strains can become established in a population within days rather than the many generations natural selection usually takes in animals or plants. Meticillin-resistant Staphylococcus aureus (MRSA) is one well-known example that now causes serious problems in hospitals across the United Kingdom. Understanding this process, essentially natural selection acting on a very short timescale, helps explain why doctors are urged to prescribe antibiotics only when necessary, and why patients are always told to complete the full course.
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