Editorials

The rise in bacterial resistance

BMJ 2000; 320 doi: http://dx.doi.org/10.1136/bmj.320.7229.199 (Published 22 January 2000) Cite this as: BMJ 2000;320:199

Is partly because there have been no new classes of antibiotics since the 1960s

  1. S G B Amyes, professor of medical microbiology (s.g.b.amyes@ed.ac.uk)
  1. Medical School, University of Edinburgh, Edinburgh EH8 9AG

    Papers p 213

    Almost since the beginning of the antibiotic era bacterial resistance has been seen as the major obstacle to successful treatment. Hardly any group of antibiotics has been introduced into clinical practice to which some bacterium has not developed resistance. Quantifying the impact of this resistance has often proved difficult, and misconceptions have often resulted from incomplete surveillance. Now that our surveillance methods are much better, we know that levels of antibiotic resistance are rising inexorably—as illustrated by this week's paper on trends in England and Wales (p 213).1 Yet it has taken a long time to realise the extent of the problem, and there is still much that we need to learn about the mechanisms.

    Resistance was often minimised as a problem simply because the problem was not known or recognised. At the end of the 1960s the surgeon general of the United States stated that “we could close the book on infectious diseases.” Although those words seem naive now, at the time they were said the emergence of …

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