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Chapter 42 : Concluding Remarks
In spite of the earlier discovery of penicillin, it was perhaps the discovery of streptomycin for the treatment of tuberculosis that was the most important and most dramatic event in the history of infectious diseases. The introduction of an effective treatment for the “white plague” was of paramount and worldwide importance. Antibiotic treatments for other diseases in history such as cholera, plague, and syphilis soon followed, and the golden age of antibiotics began. The problems of antibiotic resistance were minimalized at first, because laboratory studies showed that mutations associated with antibiotic resistance, while possible, were rare (streptomycin was the model antibiotic at the time) and that resistant mutants appeared at such low frequencies that they would not be expected to be an impediment to therapeutic antibiotic use. The bacterial geneticists could not have realized how wrong they were! Streptomycin-resistant Mycobacterium tuberculosis, sulfonamide-resistant Streptococcus pneumoniae, and other antibiotic-resistant pathogens appeared in the clinic and were associated with treatment failure and increased mortality. In fact, the famed writer and socialist George Orwell died when his M. tuberculosis infection no longer responded to streptomycin.