Maryn McKenna: What do we do when antibiotics don’t work any more?

Maryn McKenna: What do we do when antibiotics don’t work any more?

This is my great uncle, my father’s father’s younger brother. His name was Joe McKenna. He was a young husband
and a semi-pro basketball player and a fireman in New York City. Family history says
he loved being a fireman, and so in 1938, on one of his days off, he elected to hang out at the firehouse. To make himself useful that day,
he started polishing all the brass, the railings on the fire truck,
the fittings on the walls, and one of the fire hose nozzles, a giant, heavy piece of metal, toppled off a shelf and hit him. A few days later,
his shoulder started to hurt. Two days after that, he spiked a fever. The fever climbed and climbed. His wife was taking care of him, but nothing she did made a difference,
and when they got the local doctor in, nothing he did mattered either. They flagged down a cab
and took him to the hospital. The nurses there recognized right away
that he had an infection, what at the time they would
have called “blood poisoning,” and though they probably didn’t say it, they would have known right away that there was nothing they could do. There was nothing they could do
because the things we use now to cure infections didn’t exist yet. The first test of penicillin,
the first antibiotic, was three years in the future. People who got infections
either recovered, if they were lucky, or they died. My great uncle was not lucky. He was in the hospital for a week,
shaking with chills, dehydrated and delirious, sinking into a coma as his organs failed. His condition grew so desperate that the people from his firehouse
lined up to give him transfusions hoping to dilute the infection
surging through his blood. Nothing worked. He died. He was 30 years old. If you look back through history, most people died the way
my great uncle died. Most people didn’t die
of cancer or heart disease, the lifestyle diseases that afflict us
in the West today. They didn’t die of those diseases
because they didn’t live long enough to develop them. They died of injuries — being gored by an ox, shot on a battlefield, crushed in one of the new factories
of the Industrial Revolution — and most of the time from infection, which finished what those injuries began. All of that changed
when antibiotics arrived. Suddenly, infections that had
been a death sentence became something
you recovered from in days. It seemed like a miracle, and ever since, we have been living inside
the golden epoch of the miracle drugs. And now, we are coming to an end of it. My great uncle died in the last days
of the pre-antibiotic era. We stand today on the threshold
of the post-antibiotic era, in the earliest days of a time
when simple infections such as the one Joe had
will kill people once again. In fact, they already are. People are dying of infections again
because of a phenomenon called antibiotic resistance. Briefly, it works like this. Bacteria compete against each other
for resources, for food, by manufacturing lethal compounds
that they direct against each other. Other bacteria, to protect themselves, evolve defenses against
that chemical attack. When we first made antibiotics, we took those compounds into the lab
and made our own versions of them, and bacteria responded to our attack
the way they always had. Here is what happened next: Penicillin was distributed in 1943, and widespread penicillin resistance
arrived by 1945. Vancomycin arrived in 1972, vancomycin resistance in 1988. Imipenem in 1985, and resistance to in 1998. Daptomycin, one of
the most recent drugs, in 2003, and resistance to it
just a year later in 2004. For 70 years, we played
a game of leapfrog — our drug and their resistance, and then another drug,
and then resistance again — and now the game is ending. Bacteria develop resistance so quickly
that pharmaceutical companies have decided making antibiotics
is not in their best interest, so there are infections
moving across the world for which, out of the more
than 100 antibiotics available on the market, two drugs might work with side effects, or one drug, or none. This is what that looks like. In 2000, the Centers for Disease
Control and Prevention, the CDC, identified a single case in a hospital in North Carolina of an infection resistant
to all but two drugs. Today, that infection, known as KPC, has spread to every state but three, and to South America, Europe and the Middle East. In 2008, doctors in Sweden diagnosed a man from India
with a different infection resistant to all but one drug that time. The gene that creates that resistance, known as NDM, has now spread
from India into China, Asia, Africa, Europe and Canada, and the United States. It would be natural to hope that these infections
are extraordinary cases, but in fact, in the United States and Europe, 50,000 people a year die of infections which no drugs can help. A project chartered
by the British government known as the Review
on Antimicrobial Resistance estimates that the worldwide toll
right now is 700,000 deaths a year. That is a lot of deaths, and yet, the chances are good
that you don’t feel at risk, that you imagine these people
were hospital patients in intensive care units or nursing home residents
near the ends of their lives, people whose infections
are remote from us, in situations we can’t identify with. What you didn’t think about,
none of us do, is that antibiotics support
almost all of modern life. If we lost antibiotics, here’s what else we’d lose: First, any protection for people
with weakened immune systems — cancer patients, AIDS patients, transplant recipients, premature babies. Next, any treatment that installs
foreign objects in the body: stents for stroke, pumps for diabetes, dialysis, joint replacements. How many athletic baby boomers
need new hips and knees? A recent study estimates
that without antibiotics, one out of ever six would die. Next, we’d probably lose surgery. Many operations are preceded by prophylactic doses of antibiotics. Without that protection, we’d lose the ability to open
the hidden spaces of the body. So no heart operations, no prostate biopsies, no Cesarean sections. We’d have to learn to fear infections
that now seem minor. Strep throat used to cause heart failure. Skin infections led to amputations. Giving birth killed,
in the cleanest hospitals, almost one woman out of every 100. Pneumonia took three children
out of every 10. More than anything else, we’d lose the confident way
we live our everyday lives. If you knew that any injury
could kill you, would you ride a motorcycle, bomb down a ski slope, climb a ladder to hang
your Christmas lights, let your kid slide into home plate? After all, the first person
to receive penicillin, a British policeman named
Albert Alexander, who was so ravaged by infection
that his scalp oozed pus and doctors had to take out an eye, was infected by doing
something very simple. He walked into his garden
and scratched his face on a thorn. That British project I mentioned
which estimates that the worldwide toll right now is 700,000 deaths a year also predicts that if we can’t
get this under control by 2050, not long, the worldwide toll
will be 10 million deaths a year. How did we get to this point where what we have to look forward to is those terrifying numbers? The difficult answer is,
we did it to ourselves. Resistance is an inevitable
biological process, but we bear the responsibility
for accelerating it. We did this by squandering antibiotics with a heedlessness
that now seems shocking. Penicillin was sold
over the counter until the 1950s. In much of the developing world,
most antibiotics still are. In the United States, 50 percent of the antibiotics given
in hospitals are unnecessary. Forty-five percent of the prescriptions
written in doctor’s offices are for conditions
that antibiotics cannot help. And that’s just in healthcare. On much of the planet, most meat animals
get antibiotics every day of their lives, not to cure illnesses, but to fatten them up
and to protect them against the factory farm conditions
they are raised in. In the United States, possibly 80 percent of the antibiotics sold every year
go to farm animals, not to humans, creating resistant bacteria
that move off the farm in water, in dust, in the meat the animals become. Aquaculture depends on antibiotics too, particularly in Asia, and fruit growing relies on antibiotics to protect apples, pears,
citrus, against disease. And because bacteria can pass
their DNA to each other like a traveler handing off
a suitcase at an airport, once we have encouraged
that resistance into existence, there is no knowing where it will spread. This was predictable. In fact, it was predicted by Alexander Fleming,
the man who discovered penicillin. He was given the Nobel Prize
in 1945 in recognition, and in an interview shortly after,
this is what he said: “The thoughtless person playing
with penicillin treatment is morally responsible
for the death of a man who succumbs to infection with a pencillin-resistant organism.” He added, “I hope this evil
can be averted.” Can we avert it? There are companies working
on novel antibiotics, things the superbugs
have never seen before. We need those new drugs badly, and we need incentives: discovery grants, extended patents, prizes, to lure other companies
into making antibiotics again. But that probably won’t be enough. Here’s why: Evolution always wins. Bacteria birth a new generation
every 20 minutes. It takes pharmaceutical chemistry
10 years to derive a new drug. Every time we use an antibiotic, we give the bacteria billions of chances to crack the codes of the defenses we’ve constructed. There has never yet been a drug they could not defeat. This is asymmetric warfare, but we can change the outcome. We could build systems to harvest data
to tell us automatically and specifically how antibiotics are being used. We could build gatekeeping
into drug order systems so that every prescription
gets a second look. We could require agriculture
to give up antibiotic use. We could build surveillance systems to tell us where resistance
is emerging next. Those are the tech solutions. They probably aren’t enough either, unless we help. Antibiotic resistance is a habit. We all know how hard it is
to change a habit. But as a society,
we’ve done that in the past. People used to toss litter
into the streets, used to not wear seatbelts, used to smoke inside public buildings. We don’t do those things anymore. We don’t trash the environment or court devastating accidents or expose others
to the possibility of cancer, because we decided those things
were expensive, destructive, not in our best interest. We changed social norms. We could change social norms
around antibiotic use too. I know that the scale
of antibiotic resistance seems overwhelming, but if you’ve ever bought
a fluorescent lightbulb because you were concerned
about climate change, or read the label on a box of crackers because you think about
the deforestation from palm oil, you already know what it feels like to take a tiny step to address
an overwhelming problem. We could take those kinds of steps
for antibiotic use too. We could forgo giving an antibiotic
if we’re not sure it’s the right one. We could stop insisting on a prescription
for our kid’s ear infection before we’re sure what caused it. We could ask every restaurant, every supermarket, where their meat comes from. We could promise each other never again to buy chicken
or shrimp or fruit raised with routine antibiotic use, and if we did those things, we could slow down the arrival
of the post-antibiotic world. But we have to do it soon. Penicillin began
the antibiotic era in 1943. In just 70 years, we walked ourselves
up to the edge of disaster. We won’t get 70 years to find our way back out again. Thank you very much. (Applause)

100 Replies to “Maryn McKenna: What do we do when antibiotics don’t work any more?”

  1. The bugs we have in Africa are so strong.i have caught one right now and the antibiotics Im on is not working.I am just getting worse.We have super bugs in Africa.

  2. LITERALLY THE ENTIRE WORLD NEEDS TO FREAKING LEARN ABOUT THIS RIGHT NOW! Do not let this scare you, talk to other about it!

  3. Is the way she talked the real concern here? Instead of thinking whether a not she was being dramatic or exaggerating, we should be able to think using our rationale that antibiotic resistance is a real threat to humans. To those who think we are doomed, we should stay hopeful. Scientists have recently come up with star-shaped polymers to break gram-negative bacteria. A new era of fighting bacteria without antibiotics! Well, that's really a breakthrough and a new hope for all of us but there's still long way to go for the new technique to be used in humans so in the meantime, we do what we can!

  4. Antibiotics is not the option! Probiotics are! 99% of the bacteria that is killed by antibiotics is all good bacteria. BetterAir is your local superhero against bacteria. Do the research yourself and find out what BetterAir can do you and your family.

  5. Ted Talk cliques of crack, in saying that at least cocaine is a plant.

    AMR bacterias are mainly in the flesh in antibiotic resistance animal flesh and secretions many of whom eat.

    A Plant based society will be the only way we avoid an AMR pandemic of 300 million human deaths by 2050.

  6. The title implied a solution to the problem. This was just a doomsday buildup with some ideas to slow it down. Should have been titled "How can we work together to slow down antibiotic resistance".

  7. a sollution of apple cider vinigar and warm water three times a day. Turmeric too if you can handle the taste.

  8. New nano grinding robot can help alter this forever because it terminates bacterias physically. But that's still under research

  9. Indeed! I have some friends and know several people who have bacteria that's eating them alive and no antibiotics can help them. I have a friend who has a bacteria that eats away her scull above her nose, started in her sinusses. She already had 3 operations and nothing works. When her scull is perforated and the bacteria will go into her brain..she will probably not survive it. I feel for her, honestly…but when I say its the fault of people consuming meat and dairy cause the animals are loaded with anti biotics and the bacteria is getting immuun to it, they laugh it away….well…depopulation on a bacteria outbreak is no SF!

  10. It's pretty simple tbh…People are lazy it's easier to pump your body full of meds then it is to take responsibility for your lifestyle choices examples food choices and how active you are.

  11. It's been tested time and time again, when you pack humans or animals together in tight spaces disease flourishes and new strains are created. We will never be able to get rid of the threat of infection completely, because it to is a competing organism. It's just like any problem in this world, prevent it from happening, take the correct precautions. Learn what causes infection, learn where the bacteria come from, learn how it's made or thrives, and minimize it's threat. There is no antibiotics for a virus, yet we manage

  12. International travel has only made the spread of disease more rapid! How STUPID that Rx is sold over-the-counter in other countries (it is in ours, fish antibiotics are and are not that different from human grade)-but NO DAMNED WONDER the bacteria of today is not fazed by any of our treatments! SMDH

  13. Long therapies with antibiotics increase all cause women's' mortality by 27%!

  14. The true tragedy of the advent of antibiotic resistant bacteria is that the poor fungi that produce these antibiotics are no longer protected.

  15. "We could" like geez, yeah I guess "we could" do a whole bunch of stuff. This was basically a standard news article saying "hey there exists multi-resistant bacteria".

  16. Sperm count at 50% in the West and still going down, now this video, then all the video's on climate change, then all the video's about how technology, robots and A.I. will destroy half the jobs over the next 20 yearsm then the population rise from 7 billion to 10 billion in the next 75 years, then the rising sea waters at the same time as fresh water becomes a huge issue.

    Can anyone say: "Prefect storm"?!!

  17. Bacteria die quickly with electrical microcurrents but the medical system black-balled all electromedicine many decades ago and now is the perfect opportunity for its return to prove once and for all which medical system is the best. (see ) People blindly assume that the current medical system is #1 because it's the best but that is far from the truth. It got there via corruption and fighting dirty.

  18. My entire family and ancestors lived into their late 90's and into their 100's. No vaccinations, no floride, no gmo's. Now our food, water, air is crap. Germ theory is good but what about fungi? Mycotoxins? And the rest of our poisoned country and we are exporting death. Poisins and war.

  19. I have a resistant UTI caused by a Klebsiella Pneumoniea bacteria. I have now almost had it a year and it makes my life a misery.

  20. Although this is a serious problem, let us have a little perspective. Yes, even a tiny cut can potentially lead to death or amputation without antibiotics, but on the other hand I have gotten quite a number of non-superficial cuts and punctures in my life for which I did not seek medical treatment and I was just fine. Granted, some fraction of the population every year would die from these relatively minor injuries without antibiotics, but the demise of antibiotics, if it is not reversed, will not make me opt to live in a bubble. Having said that, I really want antibiotics to remain effective just in case, because you never know. Life is full of uncertainty.

  21. Let's look at this forecast that 10M people per year might die of infections in a post-antibiotic era. About 7000 million people worldwide, so that would be about 1 in 700 per year, so every 10 years about 1 in every 70 persons you know will have died from an untreatable infection. Of course, I can't vouch for how accurate the initial forecast is, or for how representative any one person's social circle is of the world in general in terms of risk of infection.

  22. One cause of antibiotic resistance is the frequent use of antibiotics in farming.
    there's a petition to stop this in the UK: @t

  23. How can western medicine have been so rubbish so recently. Humans may have not understood the intricacies of how antibiotics work but they did create tinctures and medicines that worked via antibiotics. In Ancient Egypt they brewed a beer that contained antibiotics to treat illnesses….

  24. No one will ever beat population control. Whether it be predators, natural disasters, disease, terrorism or even running out of resources. The human population can only flourish for so long.

  25. I think that we should let what ever new infections kill the non resistent humans and let the immune humans to survive and breed and create a new race of immune humans, then one a new infections come, we do it again, and again. If we follow the rules of natural selection, we can win

  26. Unfortunately when I get a sinus infection Im still going to grab the antibiotics…. because pain!

  27. Thank you so much for this talk! It really opened my eyes to a lot of stuff. I already knew about the general problem, but u gave me lots of new info. This really is important, thanks a lot!

  28. Look into Cannabinoid Antibiotics. I stumbled upon this research and I'm not saying it's the answer. It's worth looking into as far as existing research, that might not have the attention it deserves.

  29. OUTLAW THE MEAT INDUSTRY! We animal rights antinatalist vegans have advocating banning breeding animals for meat for 60 years. I have.

  30. 5:50 Phew! I was afraid that was Red states spreading there for a moment. So glad it was orange.

  31. You want to compute faster than nature? Then GET OVER YOUR FUCKING ANTI-ABSTRACTION ANTI-MATH BIGOTRY and SINK SEVERAL BILLION DOLLARS INTO DIFFERENTIAL ALGEBRA and COMPUTING the motions of atoms in biological systems FASTER than they can carry them out.

  32. they don't tell you what meat uses antibiotics, just like gmos. Like produce irridation. bovine growth hormone for milk.

  33. hopefully you can use quantum computing with bacteriophages to help with this

    but anyways share this video!

  34. There are antibiotic herbs, there are antibiotic functioning essential oils, there is SILVER SOL that works as an antibiotic and it does not kill the good bacteria in the process. Think outside the box instead of shuffling the "box" of medications. Study, research, open your ears, talk to natural doctors, change your diet and improve your immune system. Re invent your health efforts!

  35. People should be allowed to have education and to do R & D work too. For example, I have been able to find new antibiotics for five decades plus, but was never allowed college, nor allowed to work without a degree. Some criminal vendors step on good antibiotics then sell the dilute, weak counterfeits for treatment of infections, also facilitating resistance. Problems do not get solved when you allow No Relevant Education and No Relevant Work, it's very simple. Learning on one's own is no benefit when a criminal government decides who may do what in every case, and no degree is a bar. Nevertheless people learn, and denying college educations will not stop them. So, the heavy oppressions and evil goverments and politicians are a major cause, think about it… People with a decent chance for education and work need not be criminals, making weak antibiotics, and poor people in various nations could afford real medical doctors who prescribe antibiotics wisely. A poor person could even become an M.D.

  36. Is this some kind of American problem that I'm too European to understand? Sure we probably get the rogue rare antibiotic meat/fruits too, but we don't down buckets of antibiotics unless we're dying, pretty much. Now Americans on the other hand, yeah, stop. Stop right now.

  37. I'm commenting in 2019. Big Pharma has continued to abandon antibiotic R&D because of lack of profits. Governments like the US have failed to fund research because it has better things to do with 'our' tax dollars like dropping bombs and bailing out Wall Street. Nearly the entire world's supply of Antibiotics are now manufactured in China and India, where issues of quality and contamination have cropped up. Antibiotic Resistance is a Global Emergency, that the failure to address, WILL KILL US!

  38. here is some more bad news to regret in the future;

    global warming.

    oil depletion.

    computers invalidating trusted news sources.

    AI taking over jobs.

    Google destroying any privacy.

  39. Lets help each other to avoid AMR antimicrobial resistance and stop abuse of antibiotic ??

    I have my own videos to share you about my antimicrobial resistance understanding

    God bless everyone

  40. She's absolutely right, obviously! The thing is – all those changes for the better in social norms that she mentions, they were never the result of our kindness and good hearts, they were established by rules and regulations that are rigidly enforced. In this case, I reckon banning the use of antibiotics in agriculture would be a good first step.

  41. Good news, this planet suffer a grave infection called humans, bacteria are the cure to this infection. Task with limiting the spread and number of humans and killing the weakest and most useless ones.

    I would take a great pleasure in seeing creationist dying from antibiotics resistant bacteria. Killed by the truth they denied.

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