If Alexander Fleming had tidied the laboratory before his vacation in 1928, antibiotics would not have been discovered so soon. On his return, the London physician and bacteriologist found a moldy Petri dish. He was astonished to see that no bacteria were growing near the Penicillium notatum mold. Did the blue-green microbe secrete something that inhibited the single-celled organisms—an antibacterial substance perhaps? Fleming pursued the matter—and since the publication of his research results in 1929, he has been regarded as the discoverer of the world’s first antibiotic. It took more than ten years until Howard Florey and Ernst Boris Chain succeeded in preparing Fleming’s “penicillin” in a manner that made it possible to inject it into patients. However, pharmaceutical companies were already producing tons of the active ingredient by 1943. This saved thousands of lives, as penicillin made it possible for the first time to cure infections that were previously often fatal.
Fleming, Florey, and Chain were awarded the Nobel Prize in Medicine in 1945 for their work. In his acceptance speech, Fleming spoke of the dangers: “It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body.” He warned that this could lead to the resistant bacteria infecting other people who penicillin would no longer be able to help.
Every antibiotic inhibits most of the bacteria it is targeted at. However, sometimes some bacteria survive—if they are resistant due to a random mutation—and then multiply. Bacteria are also able to exchange genes with each other. This means that resistance can spread quickly. Sometimes germs develop their own resistance mechanisms as well. After some time, they manage to break down the antibiotic or transport it out of their cells. The more widely and more frequently antibiotics are used, the more likely it is that resistant bacteria will develop and spread.
After Fleming’s penicillin, numerous other antibiotics were developed between 1940 and 1970, and there are now more than 80 such active pharmaceutical ingredients. However, the once sharp weapon against pathogenic bacteria has been blunted because antibiotics are increasingly often proving ineffective. Due to the inflationary or often incorrect use of antibiotics in human medicine and livestock farming, many germs have changed over time and become resistant to the once effective substances.
Antibiotics are already no longer available for one in six bacterial infections, which is why around 1.3 million people die every year (see Data Mining). Since 2022, the World Health Organization (WHO) has classified antibiotic resistance as a “global threat”—partly because the development of new substances is lagging behind. In addition, WHO Director-General Tedros Adhanom Ghebreyesus has warned that ”antimicrobial resistance is outpacing advances in modern medicine.”
It starts with the bacterium
How resistance to antibiotics develops
1.
In the body (and elsewhere) “good” bacteria live that protect against disease, but also harmful bacteria that cause illness, and a few bacteria that happen to be resistant.
2.
An antibiotic kills almost all bacteria, i.e. the “good” and the pathogenic ones. The bacteria that happen to be resistant survive, however.
3.
The resistant bacteria can multiply unhindered because the antibiotic does not affect them.
4.
They are even able to pass on their resistance to other bacteria. This is how the resistance spreads.
