Of course, that assumes that the risk of resistance developing is as large as we would assume it to be. There are anti-bacterials that are effectively immune to resistance - they attack the cells at a level where developing it will cripple essential functions to the point where the bacteria aren't viable outside a clean-room environment. Most of them, unfortunately, are too effective on mammalian cells to be a good idea in medical practice, but it should be possible in principle to tweak some to reduce or eliminate side effects without cutting into their primary efficacy, and Shan-wei could have chosen some of these for her work. There is also the fact that, as Safehold actually developed, treatment instructions were being followed, as it were, religiously. Something that has been shown to be very effective at limiting the development of resistance even to common natural antibiotics.
All that said, I will admit that it wouldn't surprise me to learn that a decent analysis of outcomes showed that the available pharmacopoeia is indeed less effective than it was 900 years ago.
Bluestrike2 wrote:evilauthor wrote:Part of my preview includes the scenes where Iris is giving birth. Hillarious dialogue aside, there's also an eye opening infodump on the state of Safehold medicine.
Yes, Safehold DOES have antibiotics and what not, most from genetically engineered plants and mosses and instructions on how to extract and use them in the Book of Pasquale. Safehold medical practice is actually almost as good as anything Earth had up until the mid-TWENTIETH century.
I only saw the end of that scene, but the presence of antibiotics is incredibly surprising. After nearly a millenia of use, one would expect most bacteria to be resistant to the few antibiotics the Book of Pasquale gives them access to, even if the Pasqualites are incredibly cautious in their use. It's not like you can just leave them instructions on how to identify, cultivate, and apply new antibiotics.
Even the use of something such as engineered phagemids (assuming you engineer some sort of crop Safeholdians can cultivate) would be problematic, both because they're specifically targeted, and because you'd eventually wind up with resistance there as well.
At some point, you'd have a situation where Pasqual's instructions cease to work effectively in the majority of certain types of cases. They might not have the scientific background to understand why, but I can't see the consequences of widespread antibiotic resistance being easily swept under the rug.
