The discovery of antibiotics heralded medicine's triumph over previously fatal diseases that once destroyed entire civilizations - thus earning their reputation as miracle drugs. But today, the terrifying reality of antibiotic-resistant bacteria resulting from our widespread misuse of antibiotics forewarns us that the miracle may be coming to an end. The seemingly innocent consumer who demands antibiotics to treat nonbacterial diseases such as the common cold or plays doctor by saving old prescriptions for later use is paving the way for a future of antibiotic failure. "What harm can it do?" is a popular refrain of people worldwide as they pop another antibiotic pill. Dr. Stuart Levy - the leading international expert on hazards of antibiotic misuse - reveals how this cavalier and naive attitude about the power of antibiotics can have deadly consequences. He explains that we are presently witnessing a massive evolutionary change in bacteria. This build-up of new antibiotic-resistant bacteria in individuals and the environment worldwide is an insidious and silent process. Thus, unwittingly consumers encounter resistant bacteria in their meat, poultry, fish, and vegetables. Unregulated dispensing of antibiotics in poorer countries breeds countless more resistant strains. Since bacteria recognize no geographical boundaries, resistant forms can travel the globe. If this trend continues to grow unchecked, we may someday find that all of our antibiotics are obsolete. Today doctors can no longer expect that their first choice of antibiotic for women's urinary tract infections or children's ear infections will work. Similarly, cancer therapy is rendered useless if patients are unable to fight infections that are sometimes resistant to eight to ten different drugs. In developing countries, people are now dying of previously treatable diseases that are no longer responsive to traditional antibiotics. These problems are just a harbinger of what will come if we do not act now. Dr. Levy, recognized by The New Yorker for his superb contributions to this field, is sending out an urgent message that the world cannot afford to ignore any longer. The goal of this unprecedented investigation into the dangers of antibiotic misuse is to protect the world community from resistant infections and ensure the success of antibiotics for generations to come

Antibiotic resistance, once a term appreciated only by microbiologists, has become a common topic in the popular press. Stuart Levy, one of the contributors to this collection, bears some of the responsibility for increasing public awareness with the publication of his book "The Antibiotic Paradox" in 1992: Misuse of antibiotics resulting in increased bacterial resistance had previously been recognized in the infectious disease community. However, Dr. Levy's eloquent public warning about the shrinking efficacy of our antibi otic armamentarium served to alert the lay person to the potential consequences of this de mise in useful therapy. Because of the proliferation of diverse antibiotic classes with increasing potency and broader activity spectra, it had been assumed that any ordinary bacterial infection could be eradicated with the proper selection of drug. However, it has become evident that we are surrounded by resistant bacteria, many of which were introduced unwittingly into our en vironment through the unnecessary use of antibiotics. When it became evident that a number of people were returning for multiple visits to their family physicians for persist ent ear infections or non-responsive bronchitis, questions were raised about the antibiotic treatments that were being prescribed. Bacteria resistant to common antibiotic regimens were being isolated more frequently, often as organisms classified as "multi-resistant" with decreased susceptibilities to two or more structural classes of agents. Nosocomial spread of these resistances was aided by the transmission of plasmid-mediated resistance factors between species.

During the post-World War II "wonder drug" revolution, antibiotics were viewed as a panacea for mastering infectious disease. This book narrates the far-reaching history of antibiotics, focusing particularly on reform efforts that attempted to fundamentally change how antibiotics are developed and prescribed

Antibiotic Resistance: Origins, Evolution, Selection and Spread Chairman: Stuart B. Levy, 1997 Over the last 50 years, the rapid increase in the use of antibiotics, not only in people, but also in animal husbandry and agriculture, has delivered a selection unprecedented in the history of evolution. Consequently, society is facing one of its gravest public health problems-the emergence of infectious bacteria with resistance to many, and in some cases all, available antibiotics. This book brings together a multidisciplinary group of experts to discuss this problem. It begins by examining the origins of resistance and goes on to look at how the use of antibiotics in human medicine and farming/agriculture has selected for resistant bacteria. Separate chapters describe the evolution of resistance determinants and how these are spread both within and between bacterial species. Finally, the book contains discussions on strategies for countering the threat of antibiotic resistance. A major re-thinking of our approach to the treatment of infectious diseases is proposed-that antibiotic resistance should be seen as a problem created by the disruption of normal microbial ecology. To restore efficacy to earlier antibiotics, and to maintain the success of new antibiotics that are introduced, we need to use these drugs in a way that ensures an ecological balance that favours the predominance of susceptible bacteria.

This Open Access volume provides in-depth analysis of the wide range of ethical issues associated with drug-resistant infectious diseases. Antimicrobial resistance (AMR) is widely recognized to be one of the greatest threats to global public health in coming decades; and it has thus become a major topic of discussion among leading bioethicists and scholars from related disciplines including economics, epidemiology, law, and political theory. Topics covered in this volume include responsible use of antimicrobials; control of multi-resistant hospital-acquired infections; privacy and data collection; antibiotic use in childhood and at the end of life; agricultural and veterinary sources of resistance; resistant HIV, tuberculosis, and malaria; mandatory treatment; and trade-offs between current and future generations. As the first book focused on ethical issues associated with drug resistance, it makes a timely contribution to debates regarding practice and policy that are of crucial importance to global public health in the 21st century.

This book is based mainly on invited and offered papers presented at the Second International Symposium on Bacterial and Bacteria-like Contaminants of Plant Tissue Cultures held at University College, Cork, Ireland in September 1996, with additional invited papers. The First International Symposium on Bacterial and Bacteria-like Contaminants of Plant Tissue Cultures was held at the same venue in 1987 and was published as Acta Horticulturae volume 225, 1988. In the intervening years there have been considerable advances in both plant disease diagnostics and in the development of structured approaches to the management of disease and microbial contamination in micropropagation. These approaches have centred on attempts to separate, spatially, the problems of disease transmission and laboratory contamination. Disease-control is best achieved by establishing pathogen-free cultures while laboratory contamination is based on subsequent good working practice. Control of losses due to pathogens and microbial contamination in vitro addresses, arguably, the most importance causes of losses in the industry; nevertheless, losses at and post establishment can also be considerable due to poor quality microplants or micro-shoots. In this symposium, a holistic approach to pathogen and microbial contamination control is evident with the recognition that micropropagators must address pathogen and microbial contamination in vitro, and diseases and microplant failure at establishment. There is increasing interest in establishing beneficial bacterial and mycorrhizal association with microplants in vitro and in vivo.

The bestselling author of "The End of Oil" turns his attention to food and finds that the system entrusted with meeting one of the most basic needs is dramatically failing us. With his trademark comprehensive global approach, Roberts investigates the startling truth about the modern food system.

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