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‘The time has come to close the book on infectious diseases. We have basically wiped out infection in the United States.’ – William Stewart, Surgeon General of the USA, 1967 (Upshur 2008).
THE discovery and production of antimicrobials was one of the most important medical discoveries of the 20th century. Beyond playing a critical role in the treatment of bacterial infections, antimicrobials have allowed the advancement of modern medicine, such as the development of advanced surgical methods and chemotherapy. It is hard to imagine what modern medicine would look like without antimicrobials, but it certainly would bear little resemblance to what we have today.
By the end of World War II, penicillin was being produced in large quantities, and its impact was highlighted by a poster that declared, ‘Thanks to penicillin he will come home’ (Hancock 2007). The now infamous quote in 1967 by the Surgeon General of the USA, William Stewart, highlights the earlier overconfidence regarding our ability to control infectious diseases. While at the time, it may have seemed to some that the microbial world was destined to be controlled by humans, the seeds for the current pandemic of antimicrobial resistance had been sown.
Concerns about antimicrobial resistance developed early in the antibiotic era. When accepting his 1945 Nobel Prize for the discovery of penicillin, Sir Alexander Fleming warned, ‘But I would like to sound one note of warning … It is …