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Introduction Antimicrobial resistance is one of the biggest threats facing global humanity. In 2014, Public Health England (now the UK Health Security Agency) launched the Antibiotic Guardian (AG) campaign as a national health promotion initiative to increase public and health professionals' commitment to reducing the threat of antibiotic resistance (ABR). The aim of this research study was to gain a snapshot of public AG attitudes towards antibiotic use, the AG campaign and illness postpledge. Methodology This research used an exploratory study design using thematic and framework analysis of semistructured, in‐depth interviews. A purposive convenience sampling strategy was used to recruit 10 participants; adults in the general population who had registered with and chosen an AG pledge via the AG online platform during November 2020 were eligible for inclusion. Interviews were conducted via Zoom. Results Six main themes were identified: campaign awareness, motivators to pledge (uncertainty about the future of ABR, personal gratification, personal responsibility, moral obligation and COVID‐19), perceptions of personal responsibility (and patient perspectives of moral obligation in clinicians), the impact of the campaign and campaign promotion. Pledging appeared to solidify existing perceptions AGs held. Behavioural motivations for responsible antibiotic behaviours stemmed from perceptions of personal responsibility, moral obligation and concerns about ABR. AGs attributed responsibility to variable patterns in overprescribing. Perceptions towards COVID‐19, coinciding with the previously established study period, appeared mixed. AGs were keen to promote responsible perceptions in relation to antibiotics, resistance and the AG campaign. However, poor social acceptability of ABR concern was raised as a barrier to campaign promotion. Discussion The AGs' longstanding commitment to antimicrobial resistance demonstrates the importance of a pre‐existing interest in the public's self‐reported judicious behaviours and decision to pledge to an ABR‐focused campaign. Presenting the local and global threat to human mortality and morbidity in a more relatable format in public messaging should be considered in future strategies promoting ABR awareness and shifts in public perceptions. More frequent messaging to existing AGs is further recommended to propagate positive behaviour change among a wider audience. Patient or Public Contribution This study was based on interviews with adult members of the public who had pledged to be AGs via the website www.AntibioticGuardian.com . Interviews were based on the public's perceptions of the AG campaign, antibiotic use and ABR.
Introduction Antimicrobial resistance is one of the biggest threats facing global humanity. In 2014, Public Health England (now the UK Health Security Agency) launched the Antibiotic Guardian (AG) campaign as a national health promotion initiative to increase public and health professionals' commitment to reducing the threat of antibiotic resistance (ABR). The aim of this research study was to gain a snapshot of public AG attitudes towards antibiotic use, the AG campaign and illness postpledge. Methodology This research used an exploratory study design using thematic and framework analysis of semistructured, in‐depth interviews. A purposive convenience sampling strategy was used to recruit 10 participants; adults in the general population who had registered with and chosen an AG pledge via the AG online platform during November 2020 were eligible for inclusion. Interviews were conducted via Zoom. Results Six main themes were identified: campaign awareness, motivators to pledge (uncertainty about the future of ABR, personal gratification, personal responsibility, moral obligation and COVID‐19), perceptions of personal responsibility (and patient perspectives of moral obligation in clinicians), the impact of the campaign and campaign promotion. Pledging appeared to solidify existing perceptions AGs held. Behavioural motivations for responsible antibiotic behaviours stemmed from perceptions of personal responsibility, moral obligation and concerns about ABR. AGs attributed responsibility to variable patterns in overprescribing. Perceptions towards COVID‐19, coinciding with the previously established study period, appeared mixed. AGs were keen to promote responsible perceptions in relation to antibiotics, resistance and the AG campaign. However, poor social acceptability of ABR concern was raised as a barrier to campaign promotion. Discussion The AGs' longstanding commitment to antimicrobial resistance demonstrates the importance of a pre‐existing interest in the public's self‐reported judicious behaviours and decision to pledge to an ABR‐focused campaign. Presenting the local and global threat to human mortality and morbidity in a more relatable format in public messaging should be considered in future strategies promoting ABR awareness and shifts in public perceptions. More frequent messaging to existing AGs is further recommended to propagate positive behaviour change among a wider audience. Patient or Public Contribution This study was based on interviews with adult members of the public who had pledged to be AGs via the website www.AntibioticGuardian.com . Interviews were based on the public's perceptions of the AG campaign, antibiotic use and ABR.
We read with interest the insightful research conducted by Nukaly et al on the topic of medical students' knowledge of antibiotic use and resistance in Saudi Arabia. 1 Their study opens an essential dialogue about the role of medical education in antimicrobial resistance (AMR), with valuable insights. As a result, we extend our gratitude towards the authors for their efforts. We have provided our comments below to further expand on this area of research, with the aim of offering additional details and recommendations for improving strategies against AMR in Saudi Arabia. It is essential to adopt a comprehensive approach to AMR with both human and environmental health considered. This should help us better understand and tackle this global health threat.As mentioned, this study offers us insight to the importance of medical student education in addressing AMR. However, health policy and patient education are also crucial in this regard. Alajel et al concludes the effectiveness of regulatory measures and public education in reducing antimicrobial sales after a nationwide antimicrobial restriction policy implemented in 2018. 2 Despite these efforts, current studies reveal poor knowledge and practices among the population regarding antibiotics and AMR, such as the research of Al-Mehmadi et al which found that it is common for people to store and reuse leftover antibiotics. 3 To effectively address AMR in Saudi Arabia beyond the sphere of medical education, comprehensive educational initiatives, stewardship programs and stricter prescription regulations should be implemented. Government-funded public awareness campaigns, similar to the Antibiotic Guardian campaign launched by Public Health England in 2014, could help motivate public commitment to address antibiotic misuse, as noted by Flintham et al. 4 In the same vein, educating farmers and agricultural workers about AMR risks and proper antibiotic use is important. Integrating global recommendations like those from the World Health Organization for the use of antibiotics in agricultural practices could help in our efforts. Reinforcing stringent regulations on non-prescription antibiotic use in the agricultural sector, like the human healthcare regulations above, may reduce antibiotic misuse.To add to this, we recommend governmental investment in comprehensive, real-time surveillance systems that span across healthcare institutions in order to closely monitor the national usage and resistance patterns of antibiotics in Saudi Arabia. This is because the country's antibiotic resistance landscape exhibits significant variations in regional resistance patterns, as demonstrated by Alhifany et al. 5 Their research shows clear potential for mapping technology to effectively visualize antibiotic resistance data. 5 Such findings highlight the need for advanced surveillance systems that quickly identify hotspots and can guide responsive, targeted interventions and resource allocation, to better control the emergence of antibiotic resistance in Saudi Arabia.Planning in all these...
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