While the Covid-19 pandemic continues to cause illness and deaths, an additional medical crisis—one flying largely under the public’s radar—has been brewing. Worldwide, strains of resistant bacteria are compromising the efficacy of antibiotics, potentially rendering millions of people vulnerable to infections that have been routinely treated.

Among many not aware of the problem’s magnitude was Joanna Georgiou, a junior in Princeton’s Department of Chemical and Biological Engineering. Prior to taking a new course called “Antibiotics: From Cradle to Grave” (CBE 411/MOL 411), she had not known of the crisis, she admitted candidly.

Now, more than half way through the course, she is fully aware of the problem—and, moreover, well-versed in all the problem’s intricacies.

“It’s been really interesting to get a deep look into this,” said Georgiou.

The course is taught by Mark Brynildsen, associate professor of chemical and biological engineering and director of the department’s undergraduate studies. It is designed to introduce students to a wide range of topics related to antibiotics, including how the intersection of science, engineering, medicine and policy have shaped the development, distribution, management and use of these drugs.

The course recently won support from Princeton University's 250th Anniversary Fund for Innovation in Undergraduate Education, which helped fund a number of class projects, including a series of twenty-minute instructional videos. These were made by Brynildsen’s graduate students and are intended to walk students through some of the 20th century’s most significant antibiotic experiments. One replicated Alexander Fleming’s famous discovery of penicillin. In another, graduate student Xuanqing (Mike) Wan reproduced Selman Waksman’s discovery of the antibiotic streptomycin, which has been effective in the treatment of tuberculosis.  

“Instead of just reading about these [discoveries] on paper, the videos did a great job of showing the experiments,” said Adam Boukind, a junior and pre-med student. “Someone performing the experiment in front of you makes the learning process clearer.”

Pointing to the innovative aspects of the class, Boukind added, “I feel less like a student and more like a fellow scientist who wants to learn about antibiotics.”

The award money also allowed Brynildsen to purchase the necessary materials for the videos—including the original penicillin and streptomycin strains used in the demonstrations.

“Without that funding,” he said, “I don’t know where we would have gotten the materials and supplies to do these things.”

The main thrust of the class, Brynildsen emphasized, is the increasing resistance of disease agents to antibiotic treatments—and exploring the possible ways to solve the problem.

“A global public health crisis that is continually building is antibiotic resistance,” said Brynildsen, whose own research has produced novel approaches to creating more effective antibiotics. “It’s a challenge that future generations will have to address. It’s a continual arms race between us and bacteria that will probably continue for a very long time.”

Since the first antibiotics were developed in the early twentieth century, they have proven useful in the treatment of many infectious diseases and illnesses by killing or halting the growth of disease agents. But these agents, such as pathogenic bacteria, are not static in the face of this onslaught; they fight back. Over time, and with widely documented overuse of antibiotics in healthcare and agriculture, bacteria develop their own strategies of survival and, through a normal evolutionary process, become resistant to the drugs designed to stop them. This has led to high levels worldwide of antibiotic resistance.

Most of the antibiotics currently in use, Brynildsen noted, were developed prior to 1990. They have lost their efficacy in the face of ever-increasing strains of infections, and the quest for new antibiotics has proven a challenge.

“Developing new antibiotics is hard,” he added. “There are multiple reasons why, of course, and they range from chemical diversity to the simple financials of developing new drugs.”

The problem has major ramifications for human health. Many of the world’s diseases, such as pneumonia, tuberculosis, blood poisoning, gonorrhea and foodborne diseases, to name a few, have made a roaring comeback and are becoming increasingly difficult to treat using antibiotics.

For Georgiou, however, the outlook is not completely dire.

“There is hope,” she said. “There are people who are working hard to find new antibiotic classes. The problem seems to be that there isn’t enough money in the industry to support the development of antibiotics. That’s concerning.”