Antibiotic Resistance — Problems, Progress, and Prospects

Abstract

Two major ways that modern medicine saves lives are through antibiotic treatment of severe infections and the performance of medical and surgical procedures under the protection of antibiotics. Yet we have not kept pace with the ability of many pathogens to develop resistance to antibiotics that are legacies of the golden era of antibiotic discovery, the 1930s to 1960s. We call that period “golden” because success seemed routine then; we call it an “era” because it ended. When industry scientists shifted from making variants of old drugs to pursuing fundamentally new drugs with activity against resistant pathogens, they generally failed. Persistent, costly failure to discover novel antibiotics that would be destined for short-term use even if they survived the regulatory approval process led industry to change its focus to drugs whose long-term use prevents or mitigates noninfectious diseases. As people in wealthier regions run out of effective antibiotics, they come to share the lot of people in poorer regions who can't afford them to begin with.¹