Towards rational treatment of bacterial infections during extended space travel

In the next 15-30 years, manned space flight to Mars, our planetary neighbour, will become a reality and astronauts are likely to spend at least 2-3 years away from Earth. Time spent in such extreme environments will result in a diminution of immune status and profound changes in the human bacterial microflora. In microgravity, the efficacy of antibiotics is reduced and microbial mutation rates increase dramatically. These factors will impinge on the capacity to treat effectively the infections that will doubtless arise during such long and stressful endeavour. We highlight new rationales for the treatment of infectious disease that may be applicable to therapy in extreme environments such as deep space.