A Short History of Antibiotics
Posted on 5 July 2018
How antibiotics evolved from a ‘magic bullet’ to becoming the major cause of increases in drug-resistant bacteria.
There’s a secret weapon that helped the Allied forces win World War II, and it’s still being used by doctors today in the battle against deadly infections. That weapon? Antibiotics: powerful medicines that fight deadly bacterial infections. The story of how we discovered them takes us from a Scottish doctor’s messy desk, through the battlefields of World War II, all the way to the scary superbugs of our modern age.
Until about a century ago, bacteria-bred infections that we now treat quite easily – like diarrhoea or pneumonia – were among the leading causes of death. Before the 20th century, doctors used mould and plant extracts to treat infection, with very little success.
Chemotherapy for bacteria?
In 1904 German physician Paul Ehrlich had the idea of a ‘magic bullet’, which would selectively target disease-causing microbes (microscopic organisms, like bacteria), without harming any other cells. He called the process “chemotherapy” – or, therapy through the use of chemicals. Using this approach, Ehrlich used a systematic screening process to develop a treatment for syphilis and won the Nobel Prize for his efforts in 1908.
Then in 1928, Scottish physician Sir Alexander Fleming was working on a culture of disease-causing bacteria when he noticed the spores of a green mould – later identified as Penicillium chrysogenum – in one of his unwashed culture plates. On closer inspection, Fleming noticed that there were bacteria-free areas wherever the mould, or fungus, was growing on the plate. The mould was eating the bacteria!
Penicillin was then developed into one of the first medicines used to successfully treat many bacterial infections. The Allies used this ‘Wonder Drug’ to treat soldiers in hospitals and on the battlefield during the War, and in 1945 Fleming – together with the physicians who developed his accidental discovery – won the Nobel Prize.
Penicillin remains a widely-used antibiotic to this day. In 2017, The South African Medical Journal published a study which analysed the claims for members of 11 health insurance schemes in 2013. That study found that almost 72% of the prescriptions to treat acute bronchitis were antibiotics – and penicillins (27%) were the most commonly prescribed antibiotics.
Bacteria vs viruses
In South Africa, patients can only take antibiotics with a prescription but the trouble is that some doctors are too quick to prescribe them. Antibiotics fight against bacteria, not viruses – and there’s a big difference between the two. Excessive or inappropriate use of antibiotics is leading to what’s known as antimicrobial resistance (AMR), which the World Health Organisation (WHO) defines as the “ability of a micro-organism (like bacteria, viruses, and some parasites) to stop an antimicrobial (such as antibiotics, antivirals and antimalarials) from working against it”.
When germs become resistant to antibiotics, the treatments ultimately become ineffective, and common infections become harder – and sometimes impossible – to treat. A study by the Western Cape Department of Health, published in 2018, noted that 700 000 people around the world die each year from drug-resistant infections, and ‘if there is no international action, a scenario analysis has suggested that by the year 2050 this will increase to 10 million deaths annually’.
And so, within the space of barely a century, modern medicine has gone from having no effective treatment for harmful bacteria, to accidentally discovering a treatment, to over-using that treatment to the point where we may soon have to figure out a different, stronger treatment. What’s required now is internationally co-ordinated efforts to address the misuse of antibiotics.