Antibiotic Resistance: Where Does It Come From and What Can We Do About It?

Antibiotics are central to modern medicine.  They are not only essential for the treatment of infectious disease but also as enablers of a myriad of procedures from surgery to cancer therapies.  Unlike other medicines though, antibiotics are vulnerable to microbial evolution.  Bacteria have developed a plethora of responses to the selective pressure of antibiotics that threaten our continued use of these vital drugs.  Where does this resistance come from?  Surprisingly antibiotic resistance is widespread across microbial communities; it is found not only in pathogenic bacteria but also in benign microbes in environments across the globe.  Furthermore, this is not a new phenomenon, but extends deep into the past.  Faced with the ubiquity of resistance, what are our options for the future?  Where will the new antibiotics come from?  Recent advances in the fields of Systems and Synthetic Biology may help stem the tide.