Dr. Michael Egnor is, [once again](http://www.evolutionnews.org/2007/03/another_postcard_from_a_bastio.html), trying to explain why evolution isn't important to medicine. This time he's responding [to Mark Chu-Carroll's post on Tautology](http://scienceblogs.com/goodmath/2007/03/basics_tautology_with_a_free_b_1.php). In his latest post, Egnor continues to challenge the conventional wisdom that an understanding of evolution in general and natural selection in particular is essential to understanding and dealing with the phenomenon of bacterial resistance to antibiotics.
Here's his latest statement along those lines:
Mark, your dad’s illness didn’t happen because his doctor didn’t know enough about random mutation and natural selection. Our battle against bacterial resistance to antibiotics depends on the study of the intricate molecular strategies bacteria use to fight antibiotics, and our development of new antibiotics is a process of designing drugs to counter the bacterial strategies. We use molecular biology, microbiology, and pharmacology. We understand that bacteria aren’t killed by antibiotics that they’re resistant to. We understand tautologies. Darwin isn’t a big help here.
Thus far, Dr. Egnor has only discussed the phenomenon of bacterial resistance in general. I'm going to present a pair of real, specific, and relatively recent scenarios where I think an understanding of evolution by natural selection has played an important role in public health debates involving appropriate uses of specific antibiotics. My question - and challenge - to Dr. Egnor is this: can you explain why an understanding of evolution by natural selection was really not important in these specific cases? If you cannot, can you please explain why you still believe that an understanding of evolution by natural selection is irrelevant to medicine?