ALEXANDER FLEMING LAUNCHED the antibiotic era in 1928 with the discovery that the blue-green mold Penicillium notatum had contaminated culture dishes in his London laboratory and was excreting a compound that killed staph bacteria growing on the dish. It wasn’t until 13 years later that a drug based on Fleming’s original insight was given to a human being, a British constable hospitalized for an infection. He made what seemed a miraculous recovery — until the supply of penicillin ran out, and he relapsed and died. But its brief success showed that bacterial infections, the leading cause of death for as long as people had been keeping track, could be defeated by science. That recognition ignited a half-century-long fervor for antibiotics — one which has been almost completely lost.
If you graphed the discovery of all the antibiotics that have come to market since Fleming first recognized penicillin, the curve would look like a waterslide: a quick climb up to a peak, a fast skid down, and then a long, slow bottoming out. Between the 1920s and the 1970s, 28 classes of antibiotics with novel mechanisms of action — methods of attack that pathogens have never experienced before and cannot defend against — were brought to market. In the 1980s, two classes were achieved. In the past three decades, there has been one.
Meanwhile, the popularity of the miracle drugs came with a price: the evolution of superbugs. Over the decades, bacteria accumulated self-defense mechanisms, mutations that protected them against antibiotics’ attack. Over time we learned that any deployment of an antibiotic triggered a paradox: It would save the patient it was given to, but its use would risk the development of resistance that would imperil future patients. Today, it’s estimated superbugs kill almost three-quarters of a million people around the globe annually; by 2050 that could grow to 10 million every year if the trend isn’t slowed.
And that has brought us to a crisis that nests inside the larger catastrophe of the COVID-19 pandemic: The world needs new antibiotics more than ever — for resistant infections, and now also for coronavirus patients developing pneumonia and other infections as they endure long hospital stays. Yet the problem of how to pay for the development of a new antibiotic — which can cost about $1 billion — has deprived us of the drugs just when we need them most.
Read the full story from the Boston Globe Magazine here.