Antibiotics and antimicrobial resistance – a timeline

This timeline follows the historical events related to the development and discoveries of antimicrobials and antibiotics and the growth of antimicrobial resistance (AMR).

A full transcript is underneath the timeline.

This timeline traces the development of antimicrobials – specifically antibiotics – and antimicrobial resistance.

Discovery and use of antimicrobials

Humans have used traditional medicines to treat infections for thousands of years, but the discovery of antibiotics at the beginning of the 20th century revolutionised healthcare and the treatment of infections.

Scientific discoveries

Once antibiotics were discovered, there was a ‘golden age’ of antibiotic discovery, which lasted into the 1960s. During this time, half of the antibiotics commonly used today were discovered.

Antimicrobial resistance develops

Like other living organisms, bacteria have the ability to adapt and change to new environments and challenges. This includes evolving ways to become resistant to the effects of antibiotics. Soon after antibiotics started being used, bacteria developed resistance to those antibiotics and shared their resistance with other bacteria.

Transcript

Discovery and use of antimicrobials

Humans have used traditional medicines to treat infections for thousands of years, but the discovery of antibiotics at the beginning of the 20th century revolutionised healthcare and the treatment of infections.

2500 BC – Ancient civilisations use antimicrobials in medicine

Humans have been using medicines since prehistoric times to treat various ailments – primarily herbs and other natural substances with healing properties. Ancient civilisations such as the Egyptians, Greeks and Chinese develop sophisticated medical systems that rely heavily on plant-based remedies.

1900 – Search begins for chemicals with antibiotics

During the late 1800s, German physician and scientist Paul Ehrlich begins to systematically search for a chemical agent that will selectively kill bacteria, leaving humans unharmed. His search comes to fruition in 1907 with the synthesis of the arsenic-containing organic molecule arsphenamine, which has activity against the causative agent of syphilis (Treponema pallidum).

Image: A Salvarsan treatment kit for syphilis, Germany, 1909–1912. Wellcome Images, CC BY 4.0.

1933 – Introduction of antibiotic use in animals

Antibiotics are initially used to only treat sick animals. Later, it is discovered they can be used to promote growth.

1943 – Penicillin approved for clinical use in humans

US scientists optimise penicillin production via fermentation and are able to produce enough for the Allied Armed Forces.

Image: World War II poster extolling the use of penicillin.

1940 – Soil bacteria testing for antibiotic properties

Soil bacteria testing for antibiotic properties begins in the 1940s, when researchers discover naturally occurring antimicrobials like streptomycin and cephalosporins from soil microbes. This leads to the discovery of many major antibiotic families that we know today.

1948 – First antibiotic licensed for use in animal feeds

In the United States, the antibiotic sulfaquinoxaline becomes the first antibiotic to be routinely administered in poultry feed to prevent disease.

1950 – Antibiotics used to promote animal growth and prevent plant disease

During the 1950s, antibiotics are first used as growth promoters in animal feed. Horticultural sprays of antibiotics are used to combat disease in fruit trees.

1960 – Antibiotic use increasing in global food production

In the 1960s, antibiotics are widely used to promote growth in farm animals. Some countries restrict veterinary prescription of medically important antibiotics and warn of the risk of antibiotic resistance.

1997 – Some countries restrict use of growth-promoting antibiotics

The European Union bans the use of certain antibiotics used as growth promoters in animals.

2002 – New Zealand bans use of antibiotics as growth promoters

Concerns about the development of antibiotic-resistant bacteria and the potential impact on human health lead to a ban on the use of antibiotics as growth promoters in animal feed in New Zealand. The ban applies to all antibiotics that pose an antimicrobial resistance risk to animals or humans.

2023 – 2023 onwards

In just over 100 years, antibiotics have drastically changed modern medicine and extended the average human lifespan by 23 years. The dangers of a post-antibiotic era have prompted policy makers to acknowledge this threat to human health. Appropriate use of antibiotics and preventing infection by vaccination and good hygiene are critical.

Scientific discoveries

Once antibiotics were discovered, there was a ‘golden age’ of antibiotic discovery, which lasted into the 1960s. During this time, half of the antibiotics commonly used today were discovered.

1877 – Antibiosis described

Antibiosis, a biological process where one organism inhibits the growth of another, is observed by Louis Pasteur and Robert Koch. They observe that microbes can secrete material to kill certain bacteria.

Image: Painting of Louis Pasteur by Albert Edelfelt.

1910 – First synthetic antimicrobial used in humans

Paul Ehrlich develops the first antimicrobial treatment used to treat humans – Salvarsan. It has severe side-effects, partly because it contains arsenic, a poison.

1928 – Penicillin discovered

Alexander Fleming discovers the first modern antibiotic. He observes that the growth of the Staphylococcus aureus bacteria living in Petri dishes is inhibited by substances produced by the fungus Penicillium chrysogenum. This leads to the creation of the first antibiotic, penicillin.

Image: Professor Alexander Fleming in his laboratory at St Mary's, Paddington, London in 1943.

1930 – Sulphonamides discovered

Sulphonamides are a group of synthetic antibacterial medicines. They are the first truly effective, broad-spectrum antimicrobials used for treating infection in humans and animals. They are still in use today but were largely superseded by the discovery of penicillin.

1943 – Streptomycin discovered

Streptomycin is the first antibiotic to be successful against tuberculosis.

1944 – Golden age of antibiotics

The discovery of natural product antibiotics peaks in the mid-1950s – including streptomycin, cephalosporins, tetracyclines, vancomycin and methicillin. Most of the antibiotics discovered in this ‘golden age’ – 1944 to 1966 – are still in use, but their effectiveness has been eroded by antimicrobial resistance. The rapid and relatively easy discovery of natural product antibiotics during a relatively short period leads to the excessive use of these drugs.

Image: X-ray of a patient diagnosed with tuberculosis.

1987 – Lipopeptides discovered

The last class of clinically used antibiotics is discovered.

Antimicrobial resistance develops

Like other living organisms, bacteria have the ability to adapt and change to new environments and challenges. This includes evolving ways to become resistant to the effects of antibiotics. Soon after antibiotics started being used, bacteria developed resistance to those antibiotics and shared their resistance with other bacteria.

1928 – Resistance identified

Some bacteria become resistant to the antimicrobial Salvarsen.

1933 – More resistance appears

Certain bacteria become resistant to sulphonamides.

1944 – Penicillin resistance identified

Shortly after the introduction of penicillin, resistance is identified in the bacteria Staphylococcus aureus, a common cause of serious infection in people and animals.

Image: Scanning electron micrograph of methicillin-resistant Staphylococcus aureus bacteria (yellow) and a dead human white blood cell (coloured red). National Institute of Allergy and Infectious Diseases (NIAID)/NIH, released into the public domain.

1961 – Methicillin resistance identified in the bacteria Staphylococcus aureus

The resistant bacteria are described as MRSA (methicillin-resistant Staphylococcus aureus). These bacteria are resistant to all antibiotics in the penicillin class of antibiotics so infection is difficult to treat.

1986 – Vancomycin resistance identified in the bacteria Enterococcus

Vancomycin-resistant gram-positive bacteria can become resistant to all antibiotics.

1990 – Resistance to different antibiotics continues to emerge

Resistance to common antimicrobial drugs increases, and readily treatable infections are becoming increasingly challenging to manage.

Read about the presence of antibiotic-resistant bacteria in New Zealand in the article Is the post-antibiotic era now here?

Image: Two Petri dish culture plates growing bacteria in the presence of discs containing various antibiotics.

2015 – Global AMR emergency declared

Antimicrobial resistance is declared a global emergency by the World Health Organization. The World Health Assembly adopts a global action plan on AMR.

Read about the first global report on antimicrobial resistance.