Pre-20th Century
- Ancient Times: Use of moldy bread and plant extracts in Egypt, Greece, and China to treat infections—primitive antibacterial practices.
- 1877: Louis Pasteur and Robert Koch observed that some bacteria inhibited the growth of others, suggesting microbial antagonism.
1920s–1930s: Birth of Modern Antibiotics
- 1928: Alexander Fleming discovers penicillin from Penicillium notatum, noting its ability to kill Staphylococcus aureus.
- 1932: Gerhard Domagk discovers Prontosil, a sulfonamide, the first synthetic antibiotic effective against bacterial infections.
- 1935: Sulfonamides (sulfa drugs) become widely used, laying the foundation for modern chemotherapy.
1940s: Antibiotic Era Begins
- 1940: Howard Florey and Ernst Chain isolate and purify penicillin, enabling its mass production.
- 1942: Penicillin is first used clinically to treat infections in soldiers during WWII.
- 1943: Streptomycin discovered by Selman Waksman and colleagues, the first antibiotic effective against tuberculosis.
- 1945: Fleming, Florey, and Chain share the Nobel Prize in Physiology or Medicine for penicillin.
- 1947: Resistance to penicillin is documented in Staphylococcus aureus—early sign of resistance evolution.
1950s–1960s: Golden Age of Antibiotic Discovery
- 1950: Chloramphenicol, tetracycline, and erythromycin are introduced.
- 1952: Vancomycin is isolated from Streptomyces orientalis.
- 1955: Methicillin is developed to overcome penicillin resistance.
- 1960s: Widespread development of new antibiotic classes, including cephalosporins and rifampin.
1970s–1980s: Expansion and Resistance Awareness
- 1972: Cefuroxime, a second-generation cephalosporin, is introduced.
- 1976: Emergence of methicillin-resistant Staphylococcus aureus (MRSA) strains.
- 1980s: Discovery of fluoroquinolones (e.g., ciprofloxacin) expands options against Gram-negative bacteria.
1990s: Multidrug Resistance and Limited Innovation
- 1996: Linezolid, the first oxazolidinone, is discovered—active against resistant Gram-positive bacteria.
- Late 1990s: Growing concern over multidrug-resistant organisms like VRE and ESBL-producing Enterobacteriaceae.
2000s–2010s: Resistance Crisis and Renewed Research
- 2001: Daptomycin, a lipopeptide antibiotic, is approved.
- 2009: WHO highlights antibiotic resistance as a major global threat.
- 2010s: Rise of carbapenem-resistant Enterobacteriaceae (CRE) and NDM-1 gene.
- 2015: Discovery of teixobactin, a novel class of antibiotic with low resistance potential.
- 2016: First case of MCR-1-mediated colistin resistance reported—alarming for last-resort antibiotic resistance.
2020s: Innovation and Global Response
- 2020: COVID-19 pandemic prompts increased antibiotic use and concerns about resistance surge.
- 2021: WHO updates its priority pathogens list, urging development of new antibiotics.
- 2022: New antibiotic candidates (e.g., zoliflodacin, cefiderocol) enter late-stage clinical trials.
- Ongoing: Efforts in antibiotic stewardship, phage therapy, AI-driven drug discovery, and global surveillance intensify to combat resistance.
