Unlike, say, our great-grandparents, most of us take it for granted that if we pick up a bug, we’ll be able to kill it off pretty easily with a simple prescription from the doctor. We owe that peace of mind to antibiotics, many of which were discovered and developed as medicine in the first half of the twentieth century to treat infections that were once deadly.

The rise of antibiotic-resistant bacteria (a.k.a. superbugs), however, threatens to take away that sense of security, according to the Council of Canadian Academies, which recently reported that, in 2018, 14,000 Canadians died from “resistant bacteria”—and 5,400 of them were directly attributable to antibiotic resistance. And it’s not likely to get better soon, since superbugs are on the rise.

“Yes, it’s going to be a real challenge,” explains Dr. Susan Rogers Van Katwyk, an investigator at York University’s Global Strategy Lab. “Basically, anytime that anybody anywhere in the world takes an antibiotic there’s a risk that antibiotic resistance is going to develop. That resistance then can get passed around from bacteria to bacteria and pop up later in a totally different place and cause huge problems.”

Van Katwyk says that some infections that were treatable as recently as 10 years ago are no longer responding to antibiotics. Even taking a pill, some patients will wind up admitted into the hospital for long periods to recover. And the stark reality is that not all patients will survive.

So, what happened? As recently as 75 years ago, penicillin, the first antibiotic developed for widespread medical use, was widely considered a “wonder drug.” Discovered in 1928 by Scottish microbiologist Alexander Fleming who, one day, found that a foreign mould had taken over a petri dish of staphylococcus bacteria in his famously messy lab. Why was this of interest? Because everywhere the mould went, it stopped the bacteria dead in its tracks.

Once it was established that it could treat all manner of infections, from pneumonia to gonorrhea, it was inevitable that penicillin would be an important medicine. It was the Second World War that spurred on mass-production of the antibiotic, though. In preparation for the D-Day invasion, drug manufacturers and scientists, including those at Toronto’s Connaught Laboratories, worked overtime to make large quantities of penicillin to send with allied soldiers, so they’d be more likely to survive infections.

It may have helped Allied forces win the war, but it was already starting to lose its battle against bacteria, which immediately started evolving defence mechanisms such as special enzymes that fought back against the aggressive mould. Bacteria’s trying to survive, too, after all. And, the more antibiotics we use, the more opportunities the bugs have to develop mutations that might improve their own survival odds. All we can really hope for is to slow down the evolution of the superbugs by putting the brakes on the frivolous use of antibiotics, be it on livestock, pets and, most importantly, ourselves.

“Animal use of antibiotics certainly has a contribution but, by far, the most important contribution is human antibiotic use,” says Dr. Kevin Schwartz, infectious disease physician with Public Health Ontario. “Because most of the human bacteria lives inside the human body, it’s just more directly related to the development of resistance.”

Is there anything we can do to limit our antibiotic use? I mean, when you need it, you need it, right? Both Schwartz and Van Katwyk say there’s still value in patients understanding the difference between what an antibiotic can’t treat (a virus) and what it can (an infection). And, even when it is an infection, it’s not always the first course of action. “There are definitely things that really need antibiotics, but there are also things that our human immune system can clear all by itself,” says Van Katwyk.

That’s why sometimes a doctor will advise a patient to wait a few days. And while we might not want to wait, since we’re all always anxious to get back at it, it’s often better for us than an antibiotic, which can cause short-term side effects as well as long-term microbiome damage. Antibiotics don’t target a specific bug and, instead, wipe everything out—good bacteria and bad.

Beyond not hounding medical professionals for antibiotics, the most important thing we can do, according to both Van Katwyk and Schwartz, is to prevent the spread of bacteria in the first place. Handwashing, condom-wearing (resistant strains of gonorrhea are prevalent) and making sure you’re up to date on all your vaccinations are the best things we can do for ourselves and the people around us.

“The more we use antibiotics, whether appropriately or not, the more we’re going to promote resistance,” says Schwartz, “Which means we’re going to be headed into an era where simple infections are no longer treatable and complex medical procedures like transplants are going to be less effective. We need to be more careful and treat them as a more precious resource than we have in the past so that they last going into the future.”

If not, the future may well look a lot like the more treacherous past our grandparents and great-grandparents had to endure—a time before wonder drugs and miracle cures.