Are we ready for a world without antibiotics?

Are we ready for a world without antibiotics?
The answer is clearly no! Today, antibiotics are critical to treat bacterial infections. Indeed, there are very few therapeutic compounds, if any, able to modulate the inflammatory burst during severe sepsis [42]. Anti-toxin therapy could represent a key component of the antibacterial armamentarium of the future, but it is too early to rely on this solution on a routine basis [43]. Antimicrobial peptides are deceiving, particularly when used intravenously [44]. Bacteriophages are tempting, but are not usable by the intravenous route and have not been carefully evaluated so far [45]. Resistance is also an issue with this strategy. Some plants or aromatic substances (e.g., essential oils) may have very interesting antibacterial and antitoxin activities, but again we are far from their use in daily practice [46]. Probiotics have been mentioned as a possible alternative, but could be considered today more as a complement than as a real therapeutic solution. Vaccination is certainly the most promising preventive strategy, but remains limited to a relatively small number of bacteria [47], although there are promising new vaccines entering phase III studies against S. aureus and Clostridium difficile. Without any doubt, antibiotics remain the cornerstone of antibacterial management and they are still acutely needed for the next generations. It is our duty to protect them.