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Stuart B Levy: antibiotic resistance researcher and advocate for “prudent use” of antibiotics

BMJ 2019; 367 doi: (Published 05 November 2019) Cite this as: BMJ 2019;367:l6243
  1. Ned Stafford
  1. Hamburg, Germany
  1. ns{at}
Photo credit/copyright: Alonso Nichols/Tufts University

In 1963 in Paris the young Stuart Levy was introduced, as he would describe it four decades later, “to the phenomenon of antibiotic resistance.”1 At the time, he had completed only two years of medical study in the US and had taken a fellowship in Paris to research radiation genetics at the Pasteur Institute.

Levy was introduced to antibiotic resistance during a “journal club” meeting, where he and others discussed the latest papers published in scientific journals. Tsutomu Watanabe, who with his colleagues in Japan was pioneering drug resistance research, had in early 1963 published a landmark paper in English on “infective heredity” of multidrug resistance in bacteria.2

“I was fascinated to learn about R factors, curious means of drug resistance transfer among bacteria of different genera,” Levy later recalled. “I decided to understand first hand the findings in this area.”1

Prudent use of antibiotics

Levy wrote a letter to Watanabe, asking to work in his laboratory at Keio University in Tokyo for a few months. Watanabe agreed, and Levy’s fate was sealed. He would spend the rest of his life focusing on antibiotic resistance as a pioneering medical researcher and as an impassioned advocate, working tirelessly over decades to convince his fellow doctors that antibiotics should be prescribed only when absolutely necessary.

Put more simply, and in his own words, he advocated the “prudent use” of antibiotics. He also called for advanced diagnostics to identify diseases earlier and more accurately, better to target appropriate antibiotic use.

“The difficulties we face today,” he wrote in The BMJ in 1998, “derive from misguided efforts to try to sterilise our environment by indiscriminately destroying bacteria when we should reserve our killing capabilities for cases when health is threatened by infectious strains. We should act now to restore and maintain the healthy balanced microbiology …

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