In his 1941 novel The Library of Babel, Jorge Luis Borges imagines a universe made entirely of books – every possible 410-page combination of 22 letters, a period, a comma and a space. Somewhere within are all the meaningful works ever written, but the vast majority are nonsense.

That’s how it felt when our team began a systematic evidence map on antibiotic resistance, screening over 13,000 manuscripts to find the few relevant ones to our scope. All solid research, but it was a number that could make even our most enthusiastic collaborators go pale. We were wandering our own virtual Babel. The scale reflects the urgency of tackling antimicrobial resistance (AMR) – a global threat to human health, food security and agriculture that could cause 10 million deaths annually by 2050, outstripping cancer’s current toll of 8.2 million.

Focusing on antibiotics, Nobel laureate Selman Waksman defined them as “a compound made by a microbe to destroy other microbes”. Humans have understood and used this principle for millennia, from applying mouldy bread poultices to wounds to the antibiotic “golden age” of the 1940s–1960s, when an explosion of new drugs fuelled optimism that infectious diseases might soon be a relic of the past in high-income countries.

This was the era that spawned the much-repeated (and much-misquoted) declaration attributed to US Surgeon General Dr William........

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