Do you know what “antimicrobial resistance” is?
Most people don’t. That’s one of the findings from a series of focus groups and interviews commissioned by the Wellcome Trust (where I work).
First of all, “antimicrobial”. A lot of people have never come across this word. Antimicrobials are a family of drugs that kill microorganisms. It’s a broad über-category spanning several types of drug – including antibiotics, which pretty much everyone has heard of.
You probably have a rough idea what antibiotics are, even if you don’t know the exact definition: they treat infections that are caused by bacteria. Other types of antimicrobial drug treat infections that are caused by viruses or by fungi.
So, based on that, what’s antimicrobial resistance?
This still flummoxed the people in the focus groups. They hadn’t heard the phrase, but some of them thought they could work out what it meant: it’s when a person who has taken antimicrobial drugs for a while develops a resistance to them.
It sounds logical. It’s also dangerously wrong.
Scientists and health policy makers use “antimicrobial resistance” to mean that the microbes develop a resistance to the drugs.
This is the sort of confusion that happens when you carelessly use an abstract noun like “resistance” – whose resistance to what? It’s especially confusing when you couple it with a scientific word that most people don’t know.
A better term, the research suggested, would be “drug-resistant infections”. This clearly says who is resistant to what.
People need to understand this. Not because science is cool, but because people’s behaviour contributes to the growth of infections that are immune to our best drugs. For instance, as my colleague Kate Arkless Gray says, “if people think that they will develop a resistance to antibiotics, they may be less likely to finish the full course, when in fact not finishing the course could increase the rate at which resistance develops”.
We must talk to people in a language they understand. It can be hard to appreciate how little specialist language really seeps into public awareness, but it’s essential to make the effort to understand your audience.
And that’s why we need to talk about drug-resistant infections.