You cannot assume that it is installed. There are ways around this, you can go back to distutils (but then why do you have setuptools in the first place), or you can install setuptools in setup.py (but I think this is evil).
Use setuptools only if you need it.
When it comes to setuptools vs distribubute, they are compatible, and choosing one over the other is largely up to the user. Setup.py is identical.
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