Antibiotic resistance is one of the fastest growing threats to modern health. It is no exaggeration to say that it calls for urgent attention.

In early 2012, for example, BBC news highlighted the problem of drug-resistant infections caused by bugs such as E.coli and gonorrhoea. On many occasions, Professor Dame Sally C Davies, the Chief Medical Officer for England, has given serious warnings about the consequences of antibiotic resistance.  She also created the #keepantibioticsworking campaignon Twitter.

Meanwhile, since 2015 and on a global scale, The World Health Organization (WHO) has organised World Antibiotic Awareness Week every November. Its theme is: “Antibiotics: Handle with care”.


Sometimes it must be ‘no’


For communicators the challenge is to convince those who demand antibiotics – as the ‘easy’ option  – that, sometimes, they must take ‘no’ for an answer.  I.e. must accept a provider’s evidence-based judgment when their prescription is declined.

This confronts a nexus of misunderstanding across both motivations and normative beliefs.

Granted there is some public understanding that antibiotic over-use is unwise.  But few grasp the concept of antibiotic resistance (Davies and Davies, 2010). And probably fewer still, according to C. Lee Ventola’s research, appreciate the significant healthcare and economic consequences of antibiotic-resistant infections.  Where first- and second-line treatments prove incomplete, HC professionals may escalate to more toxic, and usually far more expensive, antibiotics.

Many such patients require, by extension, extended hospitalisation and more GP visits. Not least, they may also experience higher incidence of long-term disability.


Individual challenge: emotional re-framing


To break through antibiotics resistance campaigners must migrate from general and logically-argued principles to address the individual. Person-centered approaches are essential.

Success depends on re-framing the issue.  So, today’s apparently ‘magic’ cure becomes re-defined as the start of a spiral down into increasingly severe, and antibiotic-resistant, infections.  Today’s brief relief triggers tomorrow’s increased suffering.

Pauline Norris identifies two key principles for campaigners – a research-based understanding of both:

  • The target audience’s pre-existing conceptions (motivations, beliefs); and
  • Its level of knowledge of the relationship between managing infections and antibiotics resistance.

In short, among would-be consumers, we need simultaneously to lower expectations of antibiotics’ efficacy and to raise perceptions of the severity of antibiotic-resistant infections (Norris et al., 2013).