How can we solve the antibiotic resistance crisis  - Gerry Wright - video Dailymotion

TED-Ed

Take a closer look at the challenges of antibiotic resistance and what we can do to prevent losing this vital medicine.   --  Antibiotics: behind the scenes, they enable much of modern medicine. We use them to cure infectious diseases, and to safely facilitate everything from surgery to chemotherapy to organ transplants. But we’ve stopped discovering new ones and we’re at risk of losing them forever. How did we get into this situation? Gerry Wright shares what we can do about antibiotic resistance.  Lesson by Gerry Wright, directed by Artrake Studio.

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00:00Antibiotics.

00:08Behind the scenes, they enable much of modern medicine.

00:12We use them to cure infectious diseases,

00:14but also to safely facilitate everything from surgery

00:18to chemotherapy to organ transplants.

00:21Without antibiotics, even routine medical procedures

00:25can lead to life-threatening infections,

00:28and we're at risk of losing them.

00:30Antibiotics are chemicals that prevent the growth of bacteria.

00:35Unfortunately, some bacteria have become resistant

00:39to all currently available antibiotics.

00:42At the same time, we've stopped discovering new ones.

00:46Still, there's hope that we can get ahead of the problem.

00:49But first, how did we get into this situation?

00:53The first widely used antibiotic was penicillin,

00:56discovered in 1928 by Alexander Fleming.

01:00In his 1945 Nobel Prize acceptance speech,

01:03Fleming warned that bacterial resistance had the potential

01:08to ruin the miracle of antibiotics.

01:10He was right.

01:11In the 1940s and 50s, resistant bacteria already began to appear.

01:17From then until the 1980s, pharmaceutical companies countered the problem of resistance

01:23by discovering many new antibiotics.

01:26At first, this was a highly successful and highly profitable enterprise.

01:32Over time, a couple things changed.

01:35Newly discovered antibiotics were often only effective for a narrow spectrum of infections,

01:41whereas the first ones had been broadly applicable.

01:44This isn't a problem in itself, but it does mean that fewer doses of these drugs could be sold,

01:51making them less profitable.

01:53In the early days, antibiotics were heavily overprescribed,

01:57including for viral infections they had no effect on.

02:01Scrutiny around prescriptions increased, which is good, but also lowered sales.

02:06At the same time, companies began to develop more drugs that are taken over a patient's lifetime,

02:12like blood pressure and cholesterol medications,

02:15and later, antidepressants and anti-anxiety medications.

02:20Because they are taken indefinitely, these drugs are more profitable.

02:25By the mid-1980s, no new chemical classes of antibiotics were discovered.

02:30But bacteria continued to acquire resistance,

02:34and pass it along by sharing genetic information between individual bacteria,

02:39and even across species.

02:41Now, bacteria that are resistant to many antibiotics are common,

02:46and increasingly, some strains are resistant to all our current drugs.

02:52So, what can we do about this?

02:54We need to control the use of existing antibiotics, create new ones,

02:58combat resistance to new and existing drugs,

03:02and find new ways to fight bacterial infections.

03:06The largest consumer of antibiotics is agriculture,

03:09which uses antibiotics not only to treat infections,

03:13but to promote the growth of food animals.

03:16Using large volumes of antibiotics increases the bacteria's exposure to the antibiotics,

03:22and therefore, their opportunity to develop resistance.

03:27Many bacteria that are common in animals, like Salmonella, can also infect humans,

03:32and drug-resistant versions can pass to us through the food chain,

03:37and spread through international trade and travel networks.

03:41In terms of finding new antibiotics, nature offers the most promising new compounds.

03:47Organisms like other microbes and fungi have evolved over millions of years to live in competitive environments,

03:54meaning they often contain antibiotic compounds to give them a survival advantage over certain bacteria.

04:01We can also package antibiotics with molecules that inhibit resistance.

04:07One way bacteria develop resistance is through proteins of their own that degrade the drug.

04:13By packaging the antibiotic with molecules that block the degraders,

04:18the antibiotic can do its job.

04:20Phages—viruses that attack bacteria but don't affect humans—

04:25are one promising new avenue to combat bacterial infections.

04:30Developing vaccines for common infections, meanwhile, can help prevent disease in the first place.

04:36The biggest challenge to all these approaches is funding, which is woefully inadequate across the globe.

04:43Antibiotics are so unprofitable that many large pharmaceutical companies

04:48have stopped trying to develop them.

04:50Meanwhile, smaller companies that successfully bring new antibiotics to market

04:55often still go bankrupt, like the American startup Achaogen.

05:00New therapeutic techniques like phages and vaccines face the same fundamental problem

05:06as traditional antibiotics.

05:08If they're working well, they're used just once, which makes it difficult to make money.

05:13And to successfully counteract resistance in the long term,

05:17will need to use new antibiotics sparingly,

05:20lowering the profits for their creators even further.

05:24One possible solution is to shift profits away from the volume of antibiotics sold.

05:30For example, the United Kingdom is testing a model

05:34where healthcare providers purchase antibiotic subscriptions.

05:38While governments are looking for ways to incentivize antibiotic development,

05:42these programs are still in the early stages.

05:45Countries around the world will need to do much more.

05:48But with enough investment in antibiotic development and controlled use of our current drugs,

05:54we can still get ahead of resistance.

05:57The world is full of accidental inventions that have had major impacts on our lives.

06:05The potato chip, the microwave oven, post-it notes.

06:09But did you know that the first antibiotic was invented by accident?

06:14Has any mistake in human history saved more lives?

06:18Learn more about this fascinating story with this video.

06:21You

How can we solve the antibiotic resistance crisis - Gerry Wright

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