The beginning of the end of the antibiotic era? Part I. The problem: abuse of the "miracle drugs"

Abstract

The antibiotic era began in the early 1940s with the clinical use of penicillin. Subsequent discovery, development, and clinical use of other antibiotics resulted in effective therapy against major bacterial pathogens. These drugs were so effective that bacterial infectious diseases were considered by many experts to be under complete therapeutic control. However, the scientific community grossly underestimated the remarkable genetic plasticity of these organisms and their ability, through mutations and genetic transfer, to develop resistance to antibiotics. Infectious diseases are now the world's major cause of death. The cause of bacterial reemergence as a threat to human health and life is the abuse of the "miracle drugs." The ubiquitous nature of antibiotics in the human ecosystem foments bacterial resistance and threatens to eliminate antibiotics as effective drugs for human therapeutic use.