of resistance, and if the two or more drugs in combination achieve a greater effect than simply adding their effects together (4). In all cases, the use of multiple antibiotics does increase the risk of toxicity, in the individual who is the recipient of the therapy, and should be used tentatively and carefully. It has been shown, that exact adherence to a prescribed drug regimen plays a huge role in the prevention of antibiotic-resistant bacteria (1 & 2). The sporadic use of antibiotics provides the optimum setting for resistant strains of bacteria (1) because it creates the ideal environment for the selection of these strains. That is, an environment where the particular bacterial strain is never eliminated but just weakened enough to selectively mutate.In theory, therefore, there is some justification for physicians not prescribing medications to patients they deem to be at high risk of non-compliance with a drug regimen. This is especially true in the case of HIV positive patients, who are extremely susceptible to a broad range of opportunistic bacteria and viral infections. Non-compliance with the drug regimen not only endangers the individual not complying, but other patients that could eventually benefit from the use of those specific drugs. Genetic mutations in bacteria occur readily. So readily, that frequently, bacteria will gain a defense against an antibiotic by taking up resistant genes from other bacterial cells in the vicinity of and outside the body. Therefore, a resistance built up by one individual may be passed along and endanger the lives of many individuals. The only problem inherent, in denying patients deemed unreliable access to certain drugs, is in the word deemed itself. Although there have been studies, and it is reasonable to assume that intravenous drug users would be more likely not to follow a prescribed drug regimen, or any regimen, can we deny treatment to a patient just because he or she is a...
