In that case I was referring to community-associated MRSA. It really hasn't changed much, now that you raise it. People know it's out there. They'll have their own experience as physicians in obtaining a culture and seeing there's a bit of drug resistance out there. What they don't know is, a priori, if I have a patient in front of me, what's the probability that they have a drug-resistant infection? If they think it's very high, they're going to use the big-gun antibiotic and blow it away with that antibiotic. Over a period of time, if everybody keeps doing that.... If they know the rate is only 5%, they might take a chance and stay with the more conservative antibiotic, knowing the probability is low.
They might obtain a culture, but not everyone has that luxury when they're in an ambulatory community setting. It's easy sometimes for us who are hospital-based to criticize how people are behaving out in the community as prescribers, but they also have limited resources, so they have to go based on symptoms. They don't have diagnostic tests to tell them if it is a virus or not, which we might have in a hospital.
Still, the tracking thing, giving that pre-test chance of it being resistant, is missing, and that's what we need. It's the same thing even for these ominous, critical priority pathogens: if we think in hospital that someone has one of these real superbugs and we don't know yet, and we don't have the rates, we have a problem. We're going to start using the big-gun new antibiotic that comes out and blow it away.