Fighting antibiotic resistance: We can do better!

2021-03-15

In the shadow of the corona pandemic lurks the next global health crisis. Antibiotic resistance is one of the biggest threats to global health, food security, and development today and can affect anyone, of any age, in any country. Although antibiotic resistance is something that can happen regardless of what we do, unnecessary use of antibiotics is speeding up the process. On March 15, Mirko Ancillotti will defend his thesis. His research is an in-depth look at why we use antibiotics responsibly, why we sometimes do not, and what encourages us to do better. 

One of the major challenges in the fight to prevent bacteria from becoming resistant to antibiotics is making people understand that this concerns them. In multiple studies, qualitative and quantitative, and using a wide range of methods, Mirko Ancillotti has explored how beliefs, values and preferences influence the Swedish public’s engagement in responsible antibiotics use. His findings show that people perceive antibiotic resistance as a serious problem. But at the same time, they are not necessarily worried about being affected themselves.

To make people understand what is at stake, Mirko Ancillotti suggests putting emphasis on the fact that antibiotic resistance already is a significant public health problem. Something that could contribute to individuals assuming responsibility for their own use of antibiotics, and contribution to antibiotic resistance. He suggests that this message could be helpful to policy-making on a societal level, through campaigns, and for communication on individual level, in doctor-patient communication.

 “We have a collective responsibility to act against this development. And that might mean, on occasion, that we have to set aside our personal interests. People need to be informed, and to some extent also concerned, about antibiotic resistance and how their actions will directly affect others and what the impact might be for them, their loved ones, and their neighbours,” says Mirko Ancillotti, PhD student at Uppsala University’s Centre for Research Ethics & Bioethics.

When asked to reflect on the moral dimensions of antibiotic resistance, people think of the decreasing availability of effective antibiotics as a problem of justice and equal access. Further stressing the individual and collective moral responsibility we need to take. Our collective responsibility for maintaining antibiotic effectiveness is reflected in the individual’s responsibility to make the right decisions about antibiotics use.

Mirko Ancillotti’s findings suggest that people who are aware that their use of antibiotics affects others are more likely to be responsible even if it is at a personal disadvantage. But our behaviour is affected by the knowledge that we have. If concern about rising antibiotic resistance is what we need, any public campaigns should include messages on individual health behaviour, but also on the public health and moral dimensions of antibiotic resistance, so that people can include them in their decision-making. Individual responsibility for antibiotic resistance also has an important role to play in clinical and societal communication.

In his thesis, Mirko Anciillotti has used a wide range of methods to study the Swedish public’s beliefs, values and preferences influencing engagement for responsible use of antibiotics. Based on the results, he stresses the importance of societal and cultural awareness when preparing policies to counter antibiotic resistance. Policy demands should take into account socioeconomic factors that characterise local realities. While everyone is morally responsible for minimising their own contribution to antibiotic resistance, we don’t always do so voluntarily. Sometimes because we are not able to. Effective health communication should be developed based on people’s attitudes, beliefs, and social norms that influence antibiotic resistance-related behaviours.

Ancillotti, M. Antibiotic Resistance: A Multimethod Investigation of Individual Responsibility and Behaviour, Uppsala: Acta Universitatis Upsaliensis, 2021. 

About antibiotic resistance

On their website, the World Health Organisation describes how antibiotics are medicines used to prevent and treat bacterial infections. Antibiotic resistance occurs when bacteria change in response to the use of these medicines. These bacteria may infect humans and animals, and the infections they cause are harder to treat than those caused by non-resistant bacteria. Antibiotic resistance leads to higher medical costs, prolonged hospital stays, and increased mortality. The world urgently needs to change the way it prescribes and uses antibiotics. Even if new medicines are developed, without behaviour change, antibiotic resistance will remain a major threat. Behaviour changes must also include actions to reduce the spread of infections through vaccination, hand washing, practising safer sex, and good food hygiene.

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