Antibiotics: From Accidental Discovery to Cornerstone of Medicine
From its origins as a serendipitous discovery to being successfully prescribed for nearly a century, antibiotics remain a foundation of medicine. However it has major ongoing challenges including the rise of superbugs and the development of antimicrobial resistance (AMR). There are some prospective strategies to combat AMR on the horizon.
An uncovered petri dish sitting next to an open window sitting in Scottish physician-scientist Alexander Fleming's lab became contaminated with mold spores. He saw that the bacteria in proximity to the mold colonies were dying. He isolated the mold and identified it as a member of the Penicillium genus.
Many of today's antibiotics are part of the β-lactam family, which are a derivative of penicillin. From development to approval, new antibiotics typically takes 10 to 15 years to get to market.
The rise of superbugs and antimicrobial resistance has made some bacterial infections difficult to treat and it can often take multiple, stronger antibiotics with severe side effects to treat patients. It only takes 2 years to develop bacterial resistance to new antibiotics.
According to the Centers for Disease Control and Prevention (CDC), more than 2.8 million antibiotic-resistant infections happen in the United States annually, and more than 35,000 people die as a result. There are some emerging strategies to try to combat AMR. For example, Awareness campaigns in both the US and internationally are taking place right now with the US Antibiotic Awareness Week and World Antimicrobial Awareness Week.
In addition to awareness campaigns, the US federal government is looking to engage pharmaceutical companies and encourage development of new antibiotics. The Pasteur Act is a pending bill in Congress designed to incentivize pharmaceutical companies to develop new antibiotics.
Another strategy to prevent AMR is diagnostic stewardship. Essentially, it is the ability to more efficiently diagnose bacterial infections. This type of stewardship is a means of reducing unnecessary testing, getting the diagnosis quicker, and prescribing patients the appropriate therapy in a timely manner.
November 18-24 marks both the US Antibiotic Awareness Week and the World Antimicrobial Awareness Week. It cannot be understated that the accidental discovery of penicillin and the subsequent development of antibiotics revolutionized modern medicine. Antibiotics remain a major underpinning within the overall field.
In 1928, Scottish physician-scientist Alexander Fleming began a series of experiments involving the common staphylococcal bacteria. In the fall of that year, Fleming had an uncovered petri dish sitting next to an open window in his lab, which became contaminated with mold spores. He saw that the bacteria in proximity to the mold colonies were dying, as evidenced by the dissolving and clearing of the surrounding agar gel. He was able to isolate the mold and identified it as a member of the Penicillium genus. Hence, the serendipitous discovery of the first antibiotic.1
This class of medicine has been treating patients for nearly a century, yet patients' safety is in danger with the rise of superbugs and antimicrobial resistance. Newer strategies are emerging in hopes of staving off the issue, including diagnostic stewardship and US federal government incentives.
Check out our slideshow on the development of antibiotics, the rise of AMR, and some of the prospective initiatives to combat it.
1.Tan SY, Tatsumura Y. Alexander Fleming (1881-1955): Discoverer of penicillin. Singapore Med J. 2015;56(7):366-367. doi:10.11622/smedj.2015105