Revenge of the Microbes: How Bacterial Resistance is Undermining the Antibiotic Miracle

Abstract

Professional journals days brim with new developments in field of antimicrobial resistance, and scarcely a week goes by without a flurry of new reports on super bugs in popular media. Given unrelenting blitz of information, that 2 self-proclaimed fusty old pedants could produce a fresh perspective in ongoing arms race between man and microbe is all more noteworthy. Although their traditional milieu is microbiology textbooks, Salyers and Whitt have provided a concise yet readable history of rise of resistant organisms, as well as social and economic effect of these indomitable little critters. The history, from first hints of penicillin resistance to recent rise of vancomycin resistance, is as insightful as it is entertaining. Lay readers will get a digestible dose of basic science often missing from mass media. And professionals will find kind of incisive analysis—and even a touch of humor—that is often missing from scientific journals. Both audiences will find eminently compact descriptions of major mechanisms that enable bacteria to develop and pass on resistant traits, hurdles that pharmaceutical companies face in developing new antimicrobial drugs, dilemmas doctors and patients face in finding better ways to use drugs, and a thoughtful appraisal of possible trends. In contrast to prophecies of an approaching post-antibiotic era, authors' own realistic vision of future is far from apocalyptic. Still, they worry that increasing numbers of treatment failures like those occurring in hospitals and community settings will erode confidence in healthcare system. Some diseases, they believe, will remain treatable, some new drugs will emerge, and bacteria, with 3 billion years of evolution on their side, will continue to adapt. So perhaps, they suggest, the best we can hope for is detente, a running standoff between science and bugs' remarkable ability to adapt to their changing environment.