In 1928, Alexander Flemming made an accident that would change humanity forever. When he returned from his vacation, he noticed mold growing in a petri dish of Staphylococcus bacteria and saw the bacteria was not present around the fungus, thus realising the mold secreted self-defense chemicals that would avoid the bacteria from growing- penicillin had an antibacterial effect on staphylococci and other gram-positive pathogens including anthrax and tetanus toxins. This finding was especially useful noting that the discovery took place right between the two world wars, with penicillin first used in 1941 and was in wide use throughout the mid to late 1940’s, hailed as a miracle drug.

Antibiotics work by inhibiting important processes in a bacteria, which will in turn lead to them not being able to reproduce or do basic processes such as take up water or respire. A drug of the penicillin family contains a beta-lactam core which has four members and typically a thiazolidine ring, however its structure may vary. The cell walls of bacteria to which penicillin drugs are effective are made up of peptidoglycan, which is built by DD-transpeptidase's formation of cross-links. Penicillin's beta-lactam core inhibits the DD-transpeptidase enzyme by inhibition, preventing the formation of new cross-links. Thus, the bacteria is vulnerable. Osmosis, the movement of water from a higher water potential to a lower water potential will naturally occur- which in turn causes the bacteria to die as excessive water enters the cell with broken cross links.

Antibiotics are prescribed over a certain time period, however most people stop taking them when they start to feel better. If any bacteria is still left in the host's body, the consequences can be deadly. Bacteria can replicate very quickly. Every 4 to 20 minutes, bacteria can double in size. Thus, mutations may occur. A mutation is a nucleotide being misplaced when replicating DNA, which in turn is going to affect the polypeptide created by protein synthesis. In humans, mutations can form cancer or other abnormalities, however as bacteria are unicellular organisms, mutations have different effects for them- they can create enzymes to help them fight off antibacterials. Beta-lactamase is one of the penicillinases in bacteria that fight medications. As the name suggests, it hydrolyses (breaks down with the usage of water) the beta-lactam ring of penicillin, rendering it useless. The bacteria without the gene responsible for this enzyme die, and the ones with this enzyme survive and replicate- creating genetically identical offspring. Moreover, bacteria can share DNA they keep in DNA circles called plasmids- spreading the gene of resistance.

In response to this, we keep synthesising antibiotics for every new strain of bacteria. But exactly how far can we go? Methicillin-resistant Staphylococcus aureus (MRSA) is more and more common in hospitals and prisons, and is almost untreatable. Carbapenems, one of our last hopes, had resistance first noted in 2015. Vancomycin, our drug of last resort, commonly produces allergic reactions and may lead to bone marrow suppression and hearing loss. While still obscure, bacteriophages can be a possible solution. These are viruses which exclusively attack bacteria, killing them, without the usage of antibiotics. Problems with bacteriophages include lack of funding, lack of interest due to them not being as profitable financially as antibiotics. Additionally, the solutions to these ever growing and seemingly complex problems are actually quite simple and easily adaptable into our everyday lives. The entire course of the antibiotic treatment should be completed as prescribed by the physician, and excess antibiotics should not be stored for future self medication or to share with family and friends. Narrow spectrum antibiotics should be prescribed instead of wide spectrum ones, and the antibiotics prescribed for certain diseases should be changed so the same antibiotic isn't always prescribed for the same disease. Antibiotic use in farming should be reduced as much as possible, especially when it comes to preventative medication rather than to cure infections.

In today's age of ever increasing infections and thus ever increasing antibiotic use, it is pertinent to educate oneself of the consequences of a careless approach towards widespread issues such as the aforementioned antibiotic resistance, as change can only come after awareness.

Sources; https://www.sciencemuseum.org.uk/objects-and-stories/how-was-penicillin-developed https://pmc.ncbi.nlm.nih.gov/articles/PMC5403050/ https://en.wikipedia.org/wiki/Penicillin https://www.pnnl.gov/science/highlights/highlight.asp?id=879 https://ro.wikipedia.org/wiki/Carbapenemă https://en.wikipedia.org/wiki/Vancomycin