Antibiotic resistance--problems, progress, and prospects.


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 At least some clinical isolates of many pathogenic bacterial species — Mycobacterium tuberculosis, Neisseria gonorrhoeae, Enterococcus faecium, Staphylococcus aureus, Kleb­ siella pneumoniae, Acinetobacter bau­ mannii, Pseudomonas aeruginosa, and species of enterobacter, salmonella, and shigella — are now resistant to most antibiotics. The problem seems out of control. Yet there are reasons for optimism: progress has recently been made on 4 of 10 key challenges to ensuring that antibiotics retain an effective role in medicine.2 Recognition. Alexander Fleming and Howard Walter Florey sounded the first warning about antibiotic resistance when they accepted the 1945 Nobel Prize for the discovery of penicillin. Physicians and scientists have expanded and expounded the message ever since, but it has recently begun to resonate with the public, the press, and leaders in business and government.2 In the past decade, various key organizations, including the Infectious Diseases Society of America, the Centers for Disease Control and Prevention, the World Health Organization (WHO), and the World Economic Forum, have made antibiotic resistance the focus of highly visible reports, conferences, and actions. This year, the activity seems to have accelAntibiotic Resistance — Problems, Progress, and Prospects

DOI: 10.1056/NEJMp1408040
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@article{Nathan2014AntibioticRP, title={Antibiotic resistance--problems, progress, and prospects.}, author={Carl Nathan and Otto Cars}, journal={The New England journal of medicine}, year={2014}, volume={371 19}, pages={1761-3} }