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New Antibiotics and New Resistance

机译：新抗生素和新抗药性

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Bacterial infections have been a scourge on humankind for millennia. Plague, tuberculosis, wound infections and typhoid fever have caused historical as well as personal tragedies. No wonder, then, that antibiotics were greeted as miracle drugs. For a few decades the success of antibiotic therapies was remarkable, but enthusiasm for them led to abuses. Observers disregarded the early emergence of resistant bacteria; a number of new antibiotics were still being discovered, suggesting that effective drugs would always be available. With infections deemed under control, pharmaceutical companies lost interest in developing new antibiotics. After decades of complacency and just 50 years after the first clinical use of an antibiotic, penicillin, the public health threat posed by antibiotic resistance finally gained widespread attention. Resistance made the cover of Time and Newsweek in the early 1990s; now, most people know that antibiotics can fail. Over nearly 20 years, from the early 1980s to the late 1990s, not a single truly new antibiotic was introduced into clinical use. Even now, barely a trickle has reached the market since 1999. Meanwhile, resistance keeps evolving, and drugs are rapidly losing their efficacy, resulting in increased treatment costs, loss of labor time and, of course worst of all, lost lives. My colleagues and I reviewed how bacteria evolve so quickly towards resistance some years ago ("Antibiotic Resistance," July-August 1995). Here I will discuss new discoveries on the biology of resistance, as well as efforts to either restrain or circumvent resistant organisms. In the struggle against antibiotic resistance, science is providing useful tools, and physicians are slowly realizing that antibiotics are simultaneously powerful and dangerous drugs. Ultimately, though, we will all need to change the way we deal with bacteria in the coming "post-antibiotic era."
机译：几千年来细菌感染一直是人类的祸害。瘟疫，结核病，伤口感染和伤寒已造成历史性和个人性的悲剧。因此，难怪抗生素被视为奇迹药物。几十年来，抗生素治疗取得了巨大的成功，但对它们的热情导致了滥用。观察者无视抗药性细菌的早期出现。仍在发现许多新的抗生素，这表明将一直有有效的药物。由于感染得到了控制，制药公司对开发新的抗生素失去了兴趣。经过数十年的自满，并且在首次临床使用抗生素青霉素后仅50年，由抗生素耐药性构成的公共健康威胁终于引起了广泛关注。抵抗运动在1990年代初成为《时代》和《新闻周刊》的封面人物；现在，大多数人都知道抗生素会失效。从1980年代初期到1990年代后期，近20年来，没有一种真正的新抗生素被引入临床。即使到了现在，自1999年以来，市场上几乎还没有滴滴涕。与此同时，耐药性也在不断发展，药物正在迅速失去功效，从而导致治疗成本增加，劳动时间的损失，当然，甚至最糟糕的是，生命的损失。我和我的同事回顾了几年前细菌如何迅速发展成抗药性（“抗生素抗药性”，1995年7月至8月）。在这里，我将讨论抗药性生物学的新发现，以及抑制或规避抗药性生物的努力。在与抗生素抗药性的斗争中，科学提供了有用的工具，医生们逐渐意识到，抗生素同时是强大而危险的药物。不过，最终，在即将到来的“后抗生素时代”，我们所有人都将需要改变与细菌打交道的方式。

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