The pharmaceutical industry responded to increased resistance of penicillin with the synthesis of methicillin in 1963. Methicillin is a semi synthetic penicillin derivative that uses chemically modified ß-lactam receptors to target bacteria. Initially, the treatment appeared to be effective in almost every case. However, by the mid 1970s numerous bacterial strains were developing resistance, including Haemophilus influenzae, Enterococci, Streptococcus pyogenes, and Steptococcus pneumonia. Among the most troubling developments was methicillin resistant Staphylococcus aureus (MRSA). In 1975 only 2.4% of patients had developed MRSA infections, however by 1993 the amount had swollen to over 33%. MRSA has now become the most common multiple-drug resistant in hospitals nationwide. Moreover, several hospitals have reported that no commercially available drugs are able to treat certain strains of MRSA in their hospitals. At the Columbia-Presbyterian Medical Center in New York 80% of MRSA cases were untreatable with any of the readily available antibiotics. The astounding development of methicillin resistant bacteria called for a new antibiotic.

Again, the pharmaceutical industry responded, this time with vancomycin, a drug designed to inhibit the synthesis of bacterial cell walls. Like penicillin this drug had been heralded as a wonder drug until the bacteria retaliated.Vancomycin resistant Enterococcus faecium (VRE) were isolated in several cases in 1988 in Europe. From 1989, the year VRE was first identified in the U.S., through 1993, the proportion of enterococcal isolates resistant to vancomycin has increased 20-fold. The medical community was particularly alarmed at the recent outbreaks because infection by enterococci is the leading cause of surgical wound infections and urinary tract infections. Enterococcal infection also has the potential to be very severe by causing endocarditic and central nervous system damage when left untreated. In New York City between 1989 and 1991, 100 patients developed VRE and 42 died. It was now becoming evident that the only remaining antibiotic for staphylococcal and streptococci infections, vancomycin, was becoming ineffective. 

The worst fear of physicians worldwide, that vancomycin resistance would develop in staphylococcal and streptococci infections, was realized in 1996. A 4-month-boy developed a MRSA infection at a surgical site. After treatment with vancomycin, however, the child’s condition worsened; he had developed Staphylococcus aureus resistant to vancomycin. Since that case vancomycin resistant Staphylococcus aureus has developed in four separate cases in the US The recent outbreaks of resistance to vancomycin posses a serious threat to the health many people worldwide. However, despite the need for new treatment the pharmaceutical industry has not responded. Consequently, the search must begin for alternative solutions to contain resistant microbes.