Antibiotics, in the form we know them today, are still a relatively modern invention. The now-famous serendipity of Sir. Alexander Fleming’s discovery of Penicillin, an antibacterial agent produced by bacteria, in 1928 (1) heralded the beginning of the modern ‘antibiotic era’. This discovery and subsequent development of numerous antibiotics, for the first time provided doctors with effective treatments for previously incurable infections.
However, contrary to popular belief, the story of antibiotics truly began over 3000 years ago. The Ancient Egyptians are credited with the first societally widespread use of the antimicrobial properties of honey and mouldy bread to treat infections 2, 3. There is even evidence to suggest use of these could pre-date the time of the Pharaohs3. Sadly, though, further advancements in the human understanding of antimicrobials would not occur for thousands of years.
The 'Dark Ages' for antimicrobial treatments would extend far beyond the 10th century. It was not until 1640AD when John Parkington, and his recommendation of using mould to treat conditions, finally put the medicinal folklore, which had passed the knowledge of the effectiveness of this antimicrobial from generation to generation, in to writing4.
The antibacterial properties of mould were further explored by the leading scientists of their time including pioneering work by Sir John Scott Burdon-Sanderson, Sir William Roberts and John Tyndall. Joseph Lister carried out experiments examining the antibacterial effects of Penicillium glaucum on human tissue. Combined with work from 'the Father of Microbiology', Louis Pasteur, who postulated his germ theory of disease6, the groundwork for the discovery of penicillin had been laid.
By the 20th century, there was an established understanding of how valuable effective antimicrobials could be used within a clinical setting. World War I would further spur on this line of scientific inquiry, most notably bySir Alexander Fleming.
Fleming had worked to treat soldiers from the front line and had witnessed high rates of mortality from infection. In contributions to The Lancet during the War, Fleming pondered the lack of consistent medical approach to conditions like sepsis. His accidental discovery of the first antibiotic, Penicillin, was followed by the demonstration of its effectiveness against infections, and identification of the lysozyme that made it possible.1
Penicillin would be purified by both Howard Florey and Ernst Chain soon after. The pair followed on from research into the chemical structure of the antibacterial compound by Dorothy Crowfoot Hodgkin, and developed it into a potent antibiotic7. Together, Fleming, Florey and Chain would jointly be awarded the Nobel Prize in Physiology or Medicine in 19455, which signalled that the 'antibiotic era' had begun.
The 1940's and 50's saw the discovery of a bevy of further medicines including Streptomycin, Chloramphenicol, and Tetracycline. The first generation of 'antibiotics', a term only coined by Selman Waksman8 in 1942, were born. World War II was the proving ground for treatment of infections, with field doctors using the first commercially available widespread antibiotic, the naturally derived Tyrothricin, discovered by René Dubos9.
Significant interest in antimicrobial production and development paved the way for some of the most publically recognised antibiotics of the 20th century. Momentum would stall by the mid 2000's however, with the number of new antibiotics coming to market by 20116 falling behind increasing numbers of drug resistant infections.
This has always been a risk, indeed Fleming himself warned of the possibility of antimicrobial resistance in his Nobel acceptance speech5. It will take all of us working together to tackle antimicrobial resistance, and ensure we have not reached the end of the golden age of antibiotics.
1 Fleming A. (1929). On antibacterial action of culture of Penicillium, with special reference to their use in isolation of B. influenzae. Br. J. Exp. Pathol.10, 226–236
2 Strouhal, E (1989). Life in Ancient Egypt. Norman, Oklahoma: University of Oklahoma Press. Pg. 250, 244-46
3 Pećanac M; Janjić Z; Komarcević A; Pajić M; Dobanovacki D; Misković SS (2013). "Burns treatment in ancient times". Medicinski pregled. 66 (5–6): 263–7
4 Boslaugh, SA. (2015). The SAGE Encyclopedia of Pharmacology and Society. SAGE Publications
6 Prakash S. Bisen, Mousumi Debnath, G. B. Prasad (2012) Microbes: Concepts and Applications. Wiley. Table 7.1
7 W Florey (1945). "Use of Micro-organisms for therapeutic purposes". Br Med J. 2 (4427): 635–642.
8 Calderon CB, Sabundayo BP (2007). Antimicrobial Classifications: Drugs for Bugs. In Schwalbe R, Steele-Moore L, Goodwin AC. Antimicrobial Susceptibility Testing Protocols. CRC Press. Taylor & Frances group
9 Van Epps HL (2006). "René Dubos: unearthing antibiotics". J. Exp. Med. 203 (2): 259.