The Antibiotic Pipeline — Challenges, Costs, and Values

In 1941, Skinner and Keefer vividly chronicled an astonishing 82 percent mortality among 122 consecutive patients who had been treated for Staphylococcus aureus bacteremia in the preantibiotic era.1 Of the 41 patients older than 50 years of age, only 1 (2 percent) survived. Imagine the elation a few years later over the availability of penicillin, the prototype of a new therapeutic class of drugs (see page 524). In the next few decades, well-intentioned academic leaders predicted the demise of bacterial infections.(Figure)Such irrational exuberance over the sustained benefits of antibiotics should have been tempered by at least two . . .