Timeline

1. A Timeline of Antibiotic
Resistance
See timeline above

2. Golden Era of Development
 Introduction of antibiotic agents with penicillin in the 1940s
produced a breakthrough health intervention, saving millions of
lives1
 The ‘golden era’ of antibiotic discovery in the 1940s-1960s1
 Streptomycin, tetracycline, vancomycin developed among many
others
 Commercial development of a huge number of drug classes1
 Global effort to find new antibiotics through screening of microbes1
 Many bacterial diseases receded1

3. Emergence of Resistance
 A parallel surge in strains of antibiotic resistant bacteria
appeared only years after development of the
antibiotic2
 As early as the 1940s isolates of Staphylococcus
aureus resistant to penicillin were identified2
 Although antibiotic agent discovery continued,
resistance has began to increase sharply2
 Loss of effectiveness becoming common for all
antibiotics after continued use1

4. Number of resistance causing enzymes
identified3

5. Increasing Development Gaps
and Growing Resistance
 Since the 1960s, development of antibiotics has been
declining4
 Larger gaps between development of new antibiotics4
 Only one new antibiotic agent in the last decade
 Development becoming more expensive for drug
companies4
 Many of the most effective antibacterials have now
been rendered ineffective – with many multidrug
resistant strains arising2
 Leaves an uncertain future concerning bacterial
diseases

6. References
1. Walsh C. Where will new antibiotics come from? Nature Reviews Microbiology.
2003;1(1):65-70.
2. Laxminarayan R, Duse A, Wattal C, Zaidi AK, Wertheim HF, Sumpradit N, et al.
Antibiotic resistance—the need for global solutions. The Lancet infectious diseases.
2013;13(12):1057-1098.
3. Davies J, Davies D. Origins and evolution of antibiotic resistance. Microbiology and
Molecular Biology Reviews. 2010;74(3):417-433. Figure 2 , Numbers of unique β-
lactamase enzymes identified since the introduction of the first β-lactam antibiotics; p.
421.
4. Cars O, Högberg LD, Murray M, Nordberg O, Sivaraman S, Lundborg CS, et al.
Meeting the challenge of antibiotic resistance. Bmj. 2008;337(sep18_3):a1438-a1438.
Timeline produced by Centre of Disease Control and Prevention USA, found at:
 https://thefern.org/2013/11/imagining-the-post-antibiotics-future/timeline-of-antibiotic-
resistance/