Madam Therapeutics

Antibiotic resistance has a language problem -standardize the terminology for a better global response

Clinicians have long known that microbes such as bacteria, viruses and fungi are becoming alarmingly resistant to the medicines used to treat them. But a global response to this complex health threat — commonly termed ‘antimicrobial resistance’ — requires engagement from a much broader array of players, from governments, regulators and the public, to experts in health, food, the environment, economics, trade and industry.

A recent editorial in Nature, describes that people from these disparate domains are talking past each other. Many of the terms routinely used to describe the problem are misunderstood, interpreted differently or loaded with unhelpful connotations.

A 2015 survey by the World Health Organization (WHO) in 12 countries highlighted people’s unfamiliarity with the language of antibiotic resistance2. Fewer than half of the nearly 10,000 respondents had heard of the term ‘antimicrobial resistance’. Only one-fifth were aware of its abbreviated form ‘AMR’. By contrast, more than two-thirds knew of the terms ‘antibiotic resistance’ or ‘drug resistance’. A similar study published the same year of people in the United Kingdom — by the UK biomedical charity the Wellcome Trust — revealed comparable trends

The interchangeable use of terms by the press and by scientists in publications and meetings is likely to be counterproductive in all sorts of contexts. Take food production. In recent years, different sectors have called on countries to phase out or abolish the ‘antimicrobials’ used to promote animal growth, to protect humans from increasing levels of drug-resistant bacteria4.

Simple, clear and unambiguous terminology would help to ensure that the global effort against drug resistance is focused on the greatest immediate challenge: the rise of drug-resistant bacteria that cause common illnesses, resulting from the high use of antibiotics by humans. It could also improve people’s understanding and engagement.

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