to the evolution of bacterial resistance. Consequently, the pharmaceutical industry’s incentive to manufacture new drugs that can fight them is low. Almost as soon as antibiotic use became widespread in the 1940s, the first evidence of bacteria resistance to antimicrobial therapy emerged. Initially, these were little more than curiosities. When they did infect patients, the numbers were so small that at first they were not enough to warrant much attention. But today, they have become a fact of medical life. Less than a century after the discovery of penicillin, we are beginning to lose the fight. Since the first MRSA deaths in otherwise healthy children in the US in 1998, the number of deaths from MRSA infection in the US each year has risen to tens of thousands – outstripping the number of deaths caused by AIDS. Bacterial resistance in hospitals is everywhere you look. This is a war like no other. There needs to be cultural change in our prescribing behaviours and more restraint in the use of antibiotics in farming and agriculture. And somehow, the pharmaceutical companies have to be convinced to chase the development of these less profitable drugs. Within my working lifetime, the pattern of antibiotic resistance in healthcare has transformed from a rare but notable event to a problem of epidemic proportion. If we are to avoid a return to the pre-antibiotic time with