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.
Stroppy Editor 
Comments
I agree I have always been taught to finish the whole course of any medication by my mum when I was little and I now always make sure my children and grand children finish any course of medicine. Thankfully we don’t take anything very often as seem to be quite healthy and throw of any infections quickly. 🙂
And then we have those who won’t listen even if they hear. I live in Texas and volunteer every summer at a week-long Girl Scout day camp. Although I’ve seen for years that the AMA isn’t crazy about folks using antibacterial hand sanitizers, in my state children’s camps are required to provide them–but not necessarily soap and water–near all of our restroom facilities. The nutcases in charge of my asylum surely have heard the potential dangers involved, but they just don’t get it. I’m not sure explaining how they relate to “drug-resistant infections” would help.
ugh that is infuriating! As a rule, I don’t use hand sanitizer at all, unless in the most extreme cases, like I’m about to eat and there is no soap anywhere in sight.
Antibacterial hand sanitizers are ubiquitous in British hosptials because their use has massively reduced cross-patient infections. What’s not to like? Why does the AMA object? djw: what potential dangers?
Meanwhile the folks who think that they are developing resistance to drugs and then tend not to finish their course and surelythinking as illogically as possible. If the resistance makes the drugs work less well, surely the correct response is to take *more* drugs, not fewer?
Hmph, why can’t I edit my own post? “are surely thinking”, not “and surelythinking”.
Thankfully we don’t take anything very often as seem to be quite healthy and throw of any infections quickly
Concrete language saves lives! We’re always telling clients about the dangers of using fuzzy, abstract (especially corporate) language. This clinches the argument.
As a microbiologist with a husband whose immune system has been catastrophically damaged by decades of chemotherapy (to save his life), I am conscious that any microbe that colonises any part of his body and wishes to do damage must not develop resistance to the antibiotics that are available in the UK.
His oncologist remarked five years ago ‘We have progressed to the point where we can now manage your cancer, but you may die from something else.’ That ‘something else’ is likely to be opportunistic microbes colonising bits of his body where they are not wanted and where they will do damage. And where they cannot be eradicated. It is a constant battle.
Against ‘antibiotic resistance’.
It is an apocalyptic scenario.
These are the kinds of bacteria that cause sore throats or urinary tract infections or tummy upsets in normal people, but which will kill these immuno-compromised people.
This is really getting to be very