The development of antimicrobial agents past, present and future

Abstract

Few developments in the history of medicine have had such a profound effect upon human life and society as the development of the powder to control infections due to micro-organisms. In 1969 the Surgeon General of the United States stated that it was time ‘to close the book on infectious diseases’. His optimism, which was shared by many, seemed justified at the time. In the fight against infectious disease several factors had combined to produce remarkable achievements. The first advances were mainly the result of improved sanitation and housing. These removed some of the worst foci of infectious disease and limited the spread of infection through vermin and insect parasites or by contaminated water and food. The earliest effective direct control of infectious diseases was achieved through vaccination and similar immunological methods which still play an important part in the control of infection today. The use of antimicrobial drugs for the control of infection is almost entirely a development of this century, and the most dramatic developments had taken place only since the 1930s. No longer was surgery the desperate gamble with human life it had been in the early nineteenth century. The perils of childbirth had been greatly lessened with the control of puerperal fever. The death of children and young adults from meningitis, tuberculosis and septicaemia, once commonplace, was, by the late 1960s, unusual in the developed world.