23 Mar, 15 | by BMJ
NEJM 19 Mar 2015 Vol 372
1093 “All bacteria will be susceptible to common cheap antibiotics by 2050″ is not a headline you will see in any newspaper. But I’d like you to think seriously whether this is not more likely than the widely-touted doomsday scenario of a post-antibiotic era in which we are all endangered by untreatable bacterial infections. Very few bacteria are pathogenic to humans, and those which are simply adapt to the environments we create for them. Staphylococcus aureus quickly became resistant to penicillin after it was widely introduced into hospitals and the community in the 1950s. Then in 1959 Beecham marketed meticillin as a beta-lactam antibiotic to deal with penicillinase-producing strains of S aureus. Its replacement, flucloxacillin, remains active against most staphylococcal infections in the UK, but not in the USA, where skin and tissue infections are now most commonly caused by meticillin-resistant staphylococci (MRSA). But this study shows that these infections respond well to treatment with either clindamycin or trimethoprim-sulfamethoxazole (co-trimoxazole) and that there is nothing to choose between these two cheap old antibiotics in terms of efficacy or safety.