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If you're worried about antibiotics not being effective anymore, here's the bad news – this dystopian future has already arrived in Australian hospitals.
Alarmingly, doctors are seeing patients with chronic infections that don't respond to treatment, except perhaps the strongest antibiotic, which may have adverse side effects.
Some of these patients have been overseas for cheaper surgery, not realising they can be exposed to exotic bugs. And the situation is becoming worse.
Are you planning a hip replacement at an overseas hospital sometime in the future? You'll save money but be warned – if you come back with an infection that doesn't respond to treatment, you could lose the hip.
"There are several dark thunderclouds on the horizon for which we need to prepare with a degree of urgency," writes Professor Frank Bowden in his new book, Infectious.
While the debate over antibiotic resistance has been raging for years, he is trying to raise the alert level about the "last gleam of twilight" for these wonderful drugs.
He has key messages for a world shocked by the outbreaks of Ebola and Zika, and mystified by the persistence of golden staph in hospital wards.
Bowden is a professor at the Australian National University medical school and an infectious diseases expert at Canberra Hospital.
He loves teaching and his rapport with students is obvious when a group of fourth-year students are co-opted for a photo session with their lecturer.
Bowden also loves to write and uses a readable style that appeals to publishers. And readers. His first book, Gone Viral, sold well and received solid reviews.
The publicity blurb for Infectious says: "A young woman's flu symptoms mask a rare tick infection. A man develops shingles then suffers excruciating facial pain later in life. After years of frustration, a family eradicates head lice forever.
"In the age of Ebola, Zika virus and antibiotic resistance, leading infectious diseases physician Frank Bowden offers eye-opening insights into the serious issues that keep us awake at night, and the everyday infections that affect most of us. He busts myths, reveals the latest medical breakthroughs, and explores the big issues confronting public health."
He divides the book into three themed sections: the bugs themselves; the last gleam of twilight for antibiotics; and the "disturbing tendency of some patients and doctors to diagnose and treat diseases that either don't exist or, if they do, should never be looked at".
This busy professor wants to transcend the limited audience for academic papers, and communicate the messages gained from his experience to the wider community – such as, the impact of infectious diseases.
"In some areas of medicine, we underestimate the power of infection … [but] there are things which we must never ever lose sight of," he says.
He cites sepsis or blood poisoning. "That's a medical emergency and that needs to be treated in exactly the same way as a heart attack," he says. "Across the world, we know that's not the case."
He pursues the importance of this point, particularly as the risk of dying from a heart attack has reduced over the years, for patients who make it to Accident and Emergency.
But people don't realise blood infections carry an "enormous risk" of death. "In Canberra we see as many blood stream infections as we see heart attacks," he says.
The reversal from the epidemic in heart attacks a few decades ago is a product of medical science. And children don't regularly die from measles.
The advances in pharmacology mean doctors are left to treat the more difficult cases. For instance, urinary tract infection in older people is incredible common and there is no vaccination for people who contract "golden staph".
"The idea of the book is to give people some practical ideas about what they can do themselves to guide their decision-making about antibiotics," Bowden says. "We sometimes give the wrong antibiotic for the wrong reason for the wrong time.
"Their obsolescence is an ineluctable consequence of a fundamental biological mechanism – evolution.
"In his Nobel acceptance speech in 1945, Sir Alexander Fleming, the discoverer of penicillin, predicted that Staph aureus would soon develop resistance to the drug.
"We can all help slow the resistance movement by not expecting an antibiotic for diseases that won't respond to them."
In the chapter, "antibiotic mythbusting", he looks at seven misconceptions about antibiotics he commonly hears "from my patients and, I am afraid to say, my colleagues".
The myths include "The doctor would only prescribe an antibiotic if I really needed it" and "Because antibiotics are so safe, it's OK to take one if you don't really need it, just to be on the safe side".
In a candid admission, the campaigner reveals his children have secretly sought second opinions when their medico father advised them.
And he is scathing about some members of his profession.
"Some of my non-infectious colleagues prescribed them for the flimsiest of reasons or, if they are needed, they choose the wrong one, or give the wrong dose, or continue the course for too long," he says.
"The inappropriate use of antibiotics both in the community and in hospitals is an issue of international public health significance. Antibiotic resistance is no longer a theoretical threat – it is now a clinical reality that can't be ignored. We are now at the beginning of the end of the Age of Antibiotics."
Bowden says the message about antibiotic resistance is analogous to global warming – the trend for bugs to evolve resistance to antibiotics has been apparent to doctors and scientists for years, but not to the lay person.
Research on new antibiotics has fallen away, but the bugs have kept evolving.
"Now we're at a point, all over the world, where there are germs that 10 years ago could be treated," he says.
"We are no longer talking about the future, we're talking about the present.
"Ten years ago in this hospital we never saw those [exotic] germs, now we've started to see them often.
"We've got patients on the ward at the moment who have bugs which are resistant to previously what were our most powerful antibiotics.
"Probably once a week we see a person who has a bug for which that antibiotic no longer works. Luckily we've still got some choices.
"In Australia we've still got some choices but if I was in India, every day I would see germs for which there was nothing left, absolutely nothing.
"If we were to follow what's happened in a lot of places on the Indian sub-continent and south-east Asia, we will find a significant number of our patients will present with bacteria for which we have no antibiotics that will work against them and we will then be back into the pre-antibiotic era.
"I don't know how many of the bugs would be like that but there is no question it will be an increasing problem."
Medical tourism is a particularly fraught activity, this expert says. "If you come in with an infected hip [in future years] because you've had it replaced overseas and it's infected with a germ for which we have no antibiotics, you'll have to have the hip removed."
Bowden is concerned the trend for self-diagnosis of infectious diseases has become a "widespread and disturbing distraction".
"There is, for example, no question that Lyme disease is an important infection in the United States and Europe but there is no microbiological evidence of it existing in Australia," he says.
"Yet, excluding the cases picked up in these places, each year hundreds of Australians believe they have acquired Lyme disease locally.
"Most suffer from a variety of non-specific complaints, none of which is consistent with Lyme disease as it is seen anywhere else, and many look for a doctor who will prescribe months or even years of intravenous antibiotics."
Infectious: a doctor's eye-opening insights into contagious diseases, Frank Bowden, NewSouth, $29.99 rrp
