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Few among the general public are losing sleep over antibiotic resistance or the absence of effective new antibiotics. People generally have faith or have been lulled into believing that medical scientists can develop effective new antibiotics whenever needed because they have always done so in the past.

By the time most people wake up to the realities of the situation, it will be too late. Antibiotic-resistant infections are becoming the next great equalizer, and this is not just a problem for the elderly or the immune-suppressed. Friends and family, rich and poor alike, will succumb to infections that should be curable but aren't, and everyone will be looking around for someone to blame.

And who should be blamed?

• Pushy patients who refuse to leave the office without their antibiotics, even when told they don't need them?
• Physicians who write antibiotic prescriptions for self-limiting viral illnesses out of fear of angering their patients or risking accusations of negligence?
• Farmers who treat their animals with antibiotics to keep them healthy?
• Pharmaceutical companies who won't invest in new antibiotic development?
• Or regulatory agencies that make it difficult or impossible to get a new antimicrobial through the approval process?

The many factors that have contributed to the current crisis have already been debated, but these sobering facts remain:

• More US patients die of MRSA infections than HIV/AIDS and tuberculosis combined.
• Only 2 new antibiotics -- doripenem and telavancin -- have been approved in the past 3 years.
• We have no drugs to treat infections with some strains of multi-drug-resistant gram-negative bacilli, like Pseudomonas aeruginosa and Acinetobacter baumanii.