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Understanding antibiotic resistance
Understanding antibiotic resistance

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3 Pre-antibiotic era

Before antibiotics were discovered, the treatment options for bacterial infections were limited, as you will see next.

Activity 4 Life without antibiotics

Timing: Allow about 15 minutes

Watch the following video about infection in the pre-antibiotic era. As you watch, consider:

  • a.which bacterial infections were common and what the usual outcome was
  • bacterial infections were treated.
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Video 3 Living in the eighteenth century.
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  • a.It is striking that common infections such as sore throats, which are considered ‘non-serious’ today, were often killers in the pre-antibiotic age. Routine procedures such as childbirth were also dangerous. People were not only vulnerable to potentially deadly infections like TB (tuberculosis) and meningitis, but also the infection of simple cuts or more serious wounds by opportunistic pathogens could lead to sepsis and death.
  • b.In the absence of powerful, antibacterial drugs, treatment was largely ineffectual. Examples referred to in the video are ‘bloodletting’, which was an established treatment until the 1940s, and the draining of pus from wounds and sores. Other treatments from this period, but not mentioned in the video, include herbal remedies, noxious chemicals such as mercury – used as a treatment for syphilis – and fresh air for TB. While these approaches could have helped relieve a patient’s symptoms, they did little to treat the underlying cause of the infection and outcomes were generally poor.

Unlike George Washington’s physicians, we now know that infectious diseases are caused by microorganisms. This discovery, known as germ theory, was a pivotal moment in medicine.

Activity 5 Proving germ theory

Timing: Allow about 10 minutes

Read pages 3 & 4 of the article below, about the work of Louis Pasteur and Robert Koch, who provided the scientific proof of germ theory. Why was their work so important to understanding how infectious diseases could be successfully managed?

Article 1 The history of germ theory. [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)]


Pasteur discovered the link between microorganisms and disease, while Koch established that a particular type of bacteria was responsible for a specific disease. Being able to identify the pathogen responsible prompted research into potential tailor-made treatments for specific infections.

By the early twentieth century, efforts to tackle infectious diseases were focused on finding drugs that killed the bacterial pathogen without harming the patient – so-called ‘magic bullets’. Alexander Fleming’s chance discovery in 1928 of the first antibiotic – penicillin – paved the way for research into other ‘magic bullets’ to cure bacterial infections. This was the start of the antibiotic era, which you will look at in Section 4.