How Serious is Antibiotic Resistance?

How serious is antibiotic resistance, what causes it, and what are scientists doing to fight it? In this video I talk about some of the most promising recent developments to develop new antibiotics and fight bacteria.

The recent report in The Lancet about antibiotic resistance that I mention in the introduction is this:

The WHO website about antibiotic resistance is hers:

The 2018 paper about the growth of antibiotic consumption is this:

The paper about leaf-cutting ants that use antibiotics is here:

The study which used artificial intelligence to look for new antibiotics is this:

The 2019 paper about the successful treatment with genetically modified phages is here:

The 2019 paper about the new antibiotics which I mention at 11 mins 22 seconds is this:

And finally the two papers about the peptides are those:

0:00 Intro
0:48 What are antibiotics and how do they work?
2:43 What causes antibiotic resistance and how bad is it?
6:50 What are scientists doing?
13:33 Sponsor message

[jonathanpeden]

Joke I heard: What do you give the man who has everything? Broad spectrum antibiotics

[Lucius_Chiaraviglio]

As part of my work in a microbiology lab, I did a high-throughput screen for novel anti-infectives (both antibiotics and anti-virulence compounds, which target the mechanisms that microorganisms use to hijack host cells). A terrible problem was that the chemical libraries available for this, as enormous as they are (often hundreds of thousands of compounds), have the fundamental flaw of having compounds that are easy for our chemical skills to synthesize, but leaving out major classes of compounds that would be more likely to actually do something useful. The most glaring example of this is that nearly all of the compounds (other than those in the small "known bioactives" libraries consisting of a few hundred to slightly over 10000 compounds) are planar, whereas most natural compounds including antibiotics and antivirals have a 3 dimensional structure, which is usually chiral (if you look at them in a mirror they look different from the original compound in a way that you can't undo by rotating them). Such compounds are almost completely absent from the giant compound libraries because they are much harder to synthesize, especially when trying to synthesize huge numbers of compounds in parallel.

[MrKotBonifacy]

About that "overprescription" of antibiotic "in some countries" (which tend to be the very same countries with a lot of "unfinished antibiotic courses") - back in mid-90s my friend, who back then lived in Asia, tripped nad fell while playing basketball with his friends (a leisure afternoon game "just to kill some time"), landed on his right hand sprained his wrist. And since he was a quite heavy fellow (120 kg) he decided to see a doctor "just in case", just to make sure there's nothing seriously wrong with his hand. There was no wound, just pain and a swell - so he's expected some X-ray and some topical medicine (like Burow's solution used in situations like that), and maybe some painkiller - but no, he got just a painkiller and, guess what? (Oh, how did you guessed...?)
Yep, he walked away from doctor's office with antibiotic prescription. Like, Whisky Tango Foxtrot? What for? And that wasn't some Philippine or Indonesian remote village, that was in Singapore. In a very "upscale" polyclinic, in an affluent neighbourhood. Makes you scratch your head...

[jpe]

The dangers of antibiotic-resistant bacteria were shown clearly to me when my best man for my wedding died 2 days beforehand, due to a methicillin-resistant staphylococcus aureus infection he had got a few days earlier that week.

[nziom]

I knew about the phage therapy and how promising it is but it's my first time hearing about the peptide treatment it's really interesting

[GururajBN]

You never cease to surprise me. I would have hardly expected a physicist to speak on antibiotics and alternatives. Many thanks for this instructive video.👌

[finfet]

In India Multi drug resistant tuberculosis is a problem as patients often don't complete their full dosage and TB relapses.

[michaelblacktree]

For my best friend, antibiotic resistance was literally a life or death situation. He passed away in December 2021, from a medication-resistant infection.

[dewiz]

When I was working in a Staphylococcus Aureus Epidemiology Laboratory in 1963, it was already known that the previous overuse of penicillin had led to antibiotic resistance. . . to the extent that there were bacterial strains that happily considered penicillin as food. Overuse included having penicillin to swab down lab benches. . .

And, by the way, we were using phages to identify the various strains of Staph. Phages would selectively “have no effect”, “inhibit the Staph growth” or “catalyze the Staph Culture”.

[tarmaque]

I think Phage Therapy deserves its own whole video. It's a fascinating subject.

[knarf_on_a_bike]

We've known about this for so long. I remember watching a Nova episode on PBS in the 1970s, fer gawd's sake, and scientists were warning of bacterial resistance to antibiotics back then. Their dire predictions have come true.

[ethical_researcher]

Probably somebody else already said it, but the Halicin thing might refer to AI killing life, as explained anti-biotic technically being "anti-life"

[xntumrfoivrnwf]

Hmm I just had a thought: not finishing an antibiotics course is akin to vaccinating the bacteria against the antibiotic.

[richardmolnar]

Side note on antibiotics overuse: as a pharmacist I constantly encounter such cases where the patient doesn't even have a fever, just coughing a little and the doctor immediately prescribes amoxicillin, levofloxacin, azithromycin, doxycyclin etc. Especially during this pandemic, doctors seem to be totally convinced that antibiotics work against covid. I can't understand why they think that covid is any different from other viruses in this respect. Thousands of people are taking them, in the majority of cases completely unnecessary, then everybody's wondering why the patient has developed a nice pneumonia despite taking AB-s. Maybe it's BECAUSE OF that? Mankind is actively, willingly and ardently working on destroying itself, that's all I want to say...

[robhorsch]

Excellent as always, Sabine! You did a great job of relating many of the selection issues in your video. I sat in on a deep discussion on the AMR problem a few years ago. What I learned was that better management strategies have some lower hanging fruit than finding new antimicrobials. The fact that most resistance mutations are mal-adapted in the absence of selection means that the resistance genes will be lost rather quickly when selection is removed (alas too slowly to help a sick person, but quickly enough to reduce the load of resistance genes or resistant microbes in the environment if done well). This ties into the comment by exscape below.

[SameAsAnyOtherStranger]

I guess it's a whole topic unto itself, but the detrimental effect of antibiotics on gut biome bears mention in any discussion about antibiotics. Also, how antibiotics strip away mucosal lining in the GI tract is another counter intuitive way antibiotics work and why taking enough but not too much of a course of antibiotics is so important.

[MarcSylex]

The problem is public pressure on doctors to give me them "something" to cure them even in cases when its not necessary. So many people demand a magic pill and doctors want to keep their patients (money) that they cave in as long as the customer (patient) is satisfied.

[BartdeBoisblanc]

I read somewhere that the way Bacteria must adapted to phages is completely different to how they adapted to antibiotics. Therefore have a treatment with both would be highly effective.

[davidkulmaczewski]

I saw a video on another "science" channel that tried to quantify various existential risks to humanity, essentially looking at measures of 1) how many humans could be killed, and 2) how likely the risk was. Anti-biotic resistant bacteria by far had the largest metric of anything on the chart, indicating it is the most pressing risk to humanity.

Of course, the video focused exclusively on climate change and COVID (this was back in mid 2020), both of which had *significantly* lower risk than resistant bacteria. They simply ignored this huge threat....

[lancegoodmond]

This channel has provided content that has induced emotions of both hope for and anger towards humanity. It's a fantastic and thought inducing ride; keep up to good work.