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Antibiotic Resistance:
Bacteria possess a range of mechanisms to protect the organism against the detrimental effects of environmental factors and chemicals that can impair bacterial growth and survival. These protective mechanisms arise through gene mutation and assimilation of resistance genes from plasmids, and allow bacteria to survive in the ever-changing environment.

Molecules with antibiotic properties have existed in nature long before humans discovered their properties and began to use them as therapeutic agents. The word "antibiosis" was first used by Paul Vuillemin (a student of Louis Pasteur) to describe processes that can be used to destroy life. It was later adapted by Dr. Selman Waksman to describe chemicals (antibiotics) produced by microorganisms that inhibit the growth of, or destroy, bacterium and other microorganisms.

Early work by the German scientist E. de Freudenreich showed that pigment molecules from cultures of bacillus pyocyaneus could arrest bacterial growth. However, the start of the era of modern antibiotics is attributed to the British scientist Sir Alexander Fleming, who serendipitously observed that growth of staphylococcus bacteria is prevented in the presence of penicillium mold. Subsequent research isolated and identified penicillin as the active agent; which was first used to treat serious infections in the early 1940s and led to the 1945 Nobel prize in Medicine. By the early 1940s penicillin was being used in veterinary practices, and shortly after, low-dose antibiotics were being added to the feed of food animals to prevent infection and boost production.

The importance of antimicrobial therapy in the early 20th century is demonstrated through the 3 Nobel Prizes in Medicine that were awarded for this work:

1939, Gerhard Domagk for "Further progress in chemotherapy of bacterial infections." His work described the antibacterial properties of prontosil rubrum; an industrial dye which is converted by animals to an active metabolite that blocks bacterial folic acid synthesis. While not defined as a strict antibiotic, this work confirmed that chemical agents could be used to successfully treat bacterial infections. The first patient treated with prontosil rubrum was 6- year-old Hildegard Domagk.
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1945, Alexander Fleming, Ernst Chain and Sir Howard Florey for "The discovery of penicillin and its curative effects in various infectious diseases". While Fleming is recognized worldwide for his work, Chain and Florey were also recognized by the Nobel Committee for their significant contributions toward characterizing the types of infections that can be treated with penicillin.

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1952, Selman Waksman for his work on "Streptomycin: background, isolation, properties, and utilization." Streptomycin was the first antibiotic with activity against gram-negative bacteria and mycobacterium, including strains that cause tuberculosis.
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While the advent of antibiotic therapy was initially believed to herald the end of serious bacterial infections, Fleming warned that resistance to antibiotics would occur as antibiotic use expanded. Microbes are now known to possess a profound adaptive capacity, leading to continued emergence of new resistant strains whenever a new antibiotic is introduced. This capacity continues to be underestimated by the health care professionals, the public, and policy makers alike.

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