The first antibiotic, salvarsan, was deployed in 1910. In just over 100 years antibiotics have drastically changed modern medicine and extended the average human lifespan by 23 years. The discovery of penicillin in 1928 started the golden age of natural product antibiotic discovery that peaked in the mid-1950s. Since then, a gradual decline in antibiotic discovery and development and the evolution of drug resistance in many human pathogens has led to the current antimicrobial resistance crisis. Here we give an overview of the history of antibiotic discovery, the major classes of antibiotics and where they come from. We argue that the future of antibiotic discovery looks bright as new technologies such as genome mining and editing are deployed to discover new natural products with diverse bioactivities. We also report on the current state of antibiotic development, with 45 drugs currently going through the clinical trials pipeline, including several new classes with novel modes of action that are in phase 3 clinical trials. Overall, there are promising signs for antibiotic discovery, but changes in financial models are required to translate scientific advances into clinically approved antibiotics.

中文翻译：

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抗生素：过去、现在和未来。

第一种抗生素 Salvarsan 于 1910 年投入使用。在短短 100 多年的时间里，抗生素彻底改变了现代医学，并将人类的平均寿命延长了 23 年。1928 年青霉素的发现开启了天然产物抗生素发现的黄金时代，在 1950 年代中期达到顶峰。从那时起，抗生素发现和开发的逐渐下降以及许多人类病原体耐药性的演变导致了当前的抗菌素耐药性危机。在这里，我们概述了抗生素发现的历史、抗生素的主要类别以及它们的来源。我们认为，随着基因组挖掘和编辑等新技术被用于发现具有多种生物活性的新天然产物，抗生素发现的前景一片光明。我们还报告了抗生素开发的现状，目前有 45 种药物正在进行临床试验，其中包括几个具有新作用模式的新类别，处于 3 期临床试验中。总体而言，抗生素发现有希​​望的迹象，但需要改变财务模型才能将科学进步转化为临床批准的抗生素。