The antibiotic era: historical and ethical reflections on seven decades of reform efforts

Today, as we increasingly turn our attention to antibiotic resistance and the possibility of a post-antibiotic era, it is important to consider the historical evolution of attempts to implement the "rational" use of antibiotics. Throughout such history, important ethical considerations-from debates in the 1950s over conflict of interest and the role of industry in the "education" of clinicians, through contemporary concerns over our obligations to present versus future patients-have continually simmered under the surface of such broader medical and regulatory concerns. In this talk, Scott Podolsky examines seven decades of reformers who have attempted to change how antibiotics are developed, marketed and prescribed. Tensions between antibiotic development and conservation, and between education and regulation, continue to play out today in medical offices, hospitals, industry, agricultural enterprises, and the halls of government alike.