Dr. Susan Sutherland is consulting staff at Sunnybrook Health Sciences Centre, a Choosing Wisely Canada co-lead for the Canadian Association of Hospital Dentists and an author of the toolkit, Taking the Bite Out of Tooth Pain. Big Picture: Antibiotics and Antimicrobial Resistance The discovery of penicillin has been called one of the greatest achievements of modern medicine. Antibiotics have saved millions of lives in the past century and extended the average human lifespan by 23 years.1 Not only do antibiotics cure infectious diseases, but they have also made many life-saving medical procedures possible, including cancer treatments, caesarean sections, organ transplants and open-heart surgery. But with the prevalent use of antibiotics, disease-causing bacteria have evolved to become resistant to them. They are no longer as effective at treating infections. Antimicrobial resistance is increasing worldwide and threatens to undo the progress of the last 100 years. The Golden Era In 1928, Scottish bacteriologist Alexander Fleming’s plates of Staphylococci were exposed to the air during laboratory work and contaminated by a mold. The bacteria began to die. When he tested the same mold in cultures of Meningococcus and Diphtheria bacillus, he observed the same effect. Fleming hypothesized that the mold excreted a compound that inhibited the bacteria, and, in 1929, he was able to isolate the active molecule and named it “penicillin,” the first antibiotic. In 1945, penicillin became widespread as a treatment for bacterial infections, first among soldiers and then the public. Penicillin’s effectiveness and limited side effects in humans ushered in a new era of biomedical research and discovery, during which new classes of antibiotics were found in soil bacteria, fungi and other natural sources. More than 150 antibiotics and 20 classes have been discovered since penicillin, but no new classes have been found for nearly the last 40 years. 20 | 2025 | Issue 3
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