Understanding Of Antibiotic Resistance Research Articles

Genomic revisitation and reclassification of the genus Providencia.

The Providencia genus, known to harbor opportunistic pathogens, has been a subject of interest due to its potential to cause severe infections, particularly in vulnerable individuals. Our research offers groundbreaking insights into this genus, unveiling a novel species, Providencia zhijiangensis sp. nov., and highlighting the need for a re-evaluation of existing classifications. Our comprehensive genomic assessment offers a detailed classification of 545 genomes into distinct species and lineages, revealing the rich biodiversity and intricate species diversity within the genus. The substantial presence of antibiotic-resistance genes in the Providencia genus underscores potential challenges for public health and clinical treatments. Our study highlights the pressing need for increased surveillance and research, enriching our understanding of antibiotic resistance in this realm.

A prototrophic suppressor of a Vibrio fischeri D-glutamate auxotroph reveals a member of the periplasmic broad-spectrum racemase family (BsrF).

D-Amino acids are used and produced by organisms across all domains of life, but often, their origins and roles are not well understood. In bacteria, D-ala and D-glu are structural components of the canonical peptidoglycan cell wall and are generated by dedicated racemases Alr and MurI, respectively. The more recent discovery of additional bacterial racemases is broadening our view and deepening our understanding of D-amino acid metabolism. Here, while exploring alternative PG biosynthetic pathways in Vibrio fischeri, we unexpectedly shed light on an unusual racemase, BsrF. Our results illustrate a novel mechanism for the evolution of antibiotic resistance and provide a new avenue for exploring the roles of non-canonical racemases and D-amino acids in bacteria.

Antibiotic resistance: A cross-sectional study on the characteristics, knowledge, attitudes, and practices of dairy farmers' cooperative in North Cianjur (KPSCU), Cianjur District, Indonesia.

Antibiotic resistance is a component of antimicrobial resistance and is often referred to as the silent pandemic. It is one of the causes of global health problems that must be addressed. Resistance occurs due to frequent misuse and overuse of antibiotics by dairy farmers. Therefore, this study aimed to examine the influence of the characteristics of dairy farmers and analyze the variables that directly and indirectly affected the knowledge, attitudes, and practices (KAP) of dairy farmers regarding antibiotic resistance in a dairy farmers' cooperative in North Cianjur. A cross-sectional design was used with a structured questionnaire validated by Pearson correlation and reliability tested with Alpha Cronbach. Data were obtained from interviews with 75 dairy farmers in KPSCU, Cianjur District, West Java, Indonesia. The outcome variables were analyzed using descriptive and pathway analyses. The results showed that dairy farmers had good and sufficient knowledge (42.7%), the attitude level was positive (81.3%), and all farmers had sufficient practices (100%). The results also showed that most dairy farmers were over 40 years of age, with 54.7% having elementary school education. Approximately 50.7% of farmers had been engaged in breeding for 10-20 years, 80% owned their livestock, and 76% had attended training. There was a significant relationship between age, education, training, and knowledge level. Knowledge was the primary factor influencing the overall attitude. In addition, age, education, type of business, knowledge, and attitude were factors that influenced the practice of antibiotic resistance. Training and education really influenced KAP of farmers. Therefore, the best way to reduce antibiotic resistance is by increasing farmers' knowledge and understanding of antibiotic resistance and monitoring the use of antibiotics.

Public Attitudes Towards COVID-19, Antibiotic Resistance, Preventive Measures: A Multi Center Cross-Sectional Study in the Arab Countries

Background and AimCOVID-19 has shown how crucial awareness of the need to protect public health is to global security. Antibiotic resistance due to antibiotic misuse is seen as a worldwide health issue. Antibiotic use was significant during the COVID-19 epidemic, according to several nations. This research aims to investigate public attitudes on COVID-19, antibiotic resistance, and preventive measures during the COVID-19 pandemic in the Middle East.MethodsAn online quantitative cross-sectional study in 17 Arabic nations was carried out between January 3 and March 4, 2022, using a structured questionnaire to evaluate participants’ knowledge of COVID-19, their attitudes toward the new standard during the pandemic, and their use of antibiotics, and their resistance to them. The research was available to all Arabic people over 18 nations in the middle east. A convenient snowball sampling technique was used. SPSS version 20.0 was used to analyze the data. To analyze the results, binominal logistic regression was utilized. Statistical significance was defined as a p value of 0.05.ResultsOf the 6145 responders, 24.1% believed COVID-19 might spread to asymptomatic people, whereas 13.6% thought using antibiotics would accelerate recovery from any illness. Moreover, half of the respondents said antibiotics only work against bacteria (64.6%). 70.8% of participants adopted the necessary safety measures. More than a third of respondents strongly supported placing foreign immigrants in quarantine (33%). However, more than 50% of those surveyed (52.5%) firmly supported using face masks in all public settings. Individuals with a medical education background had 2.6 times more appropriate understanding of antibiotic resistance than others. Furthermore, participants in the 30–49 age range had a better handle on the use of antibiotics and antibiotic resistance than other respondents by 1.1 times.ConclusionArab Health authorities should reconsider this health issue as soon about the inadequate level of awareness toward antibiotic use, resistance, and preventative practices during COVID-19. Many suggested strategies, especially solving the irregular antibiotic prescriptions during a COVID19 pandemic, should be implemented to increase public awareness of COVID19.

Cross-Section Observational Study to Assess Antimicrobial Resistance Prevalence among Bovine Respiratory Disease Bacterial Isolates from Commercial US Feedlots.

Antimicrobial resistance (AMR) is a global public health threat that jeopardizes efficacy of antibiotics in veterinary and human medicine. Antibiotics are commonly administered to target the bacterial component of bovine respiratory disease (BRD). The objectives of this study were to obtain a better understanding of antibiotic resistance in BRD-associated bacteria (Mannheimia haemolytica, Pasteurella multocida, and Histophilus somni), investigate the clinical significance of AMR by monitoring clinical outcomes, and determine if regional differences exist in AMR trends. Deep pharyngeal swabs were used to sample beef cattle at initial BRD diagnosis (n = 453) from US feedlots representing three geographic regions. Organisms were identified by bacterial culture and subjected to broth microdilution antimicrobial susceptibility testing. Bacterium prevalence include P. multocida (36.0%), M. haemolytica (32.7%), and H. somni (28.5%). Of the Histophilus isolates, 39.5% were resistant to at least one antimicrobial, compared to 11.7% and 8.8% Pasteurella and Mannheimia, respectively. Non-susceptibility across all organisms was 5.7 X more likely in animals that received metaphylaxis, than those that did not (p < 0.0001; OR 5.7; CI 2.6-12.5). During days on feed 21-40, non-susceptibility of Histophilus was 8.7 X more likely than Mannheimia (p = 0.0002; OR 8.7; CI 2.8 to 27.4) and 6 X more likely than Pasteurella (p = 0.0016; OR 6.0; CI 2.0-18.0).

Evolution and Emergence of Antibiotic Resistance in Given Ecosystems: Possible Strategies for Addressing the Challenge of Antibiotic Resistance.

Antibiotics were once considered the magic bullet for all human infections. However, their success was short-lived, and today, microorganisms have become resistant to almost all known antimicrobials. The most recent decade of the 20th and the beginning of the 21st century have witnessed the emergence and spread of antibiotic resistance (ABR) in different pathogenic microorganisms worldwide. Therefore, this narrative review examined the history of antibiotics and the ecological roles of antibiotics, and their resistance. The evolution of bacterial antibiotic resistance in different environments, including aquatic and terrestrial ecosystems, and modern tools used for the identification were addressed. Finally, the review addressed the ecotoxicological impact of antibiotic-resistant bacteria and public health concerns and concluded with possible strategies for addressing the ABR challenge. The information provided in this review will enhance our understanding of ABR and its implications for human, animal, and environmental health. Understanding the environmental dimension will also strengthen the need to prevent pollution as the factors influencing ABR in this setting are more than just antibiotics but involve others like heavy metals and biocides, usually not considered when studying ABR.

A cross-sectional study: farmer’s perceptions, practices, and knowledge (PPK) on antimicrobial drug (AMD) and antimicrobial drug resistance (AMDR) at rural households in selected areas of Cumilla district, Bangladesh

In response to unwise and inappropriate antimicrobial drug (AMD) use, antimicrobial drug resistance (AMDR) is rising globally. The present research was performed to find out and evaluate the perceptions, practices, and knowledge (PPK) of the farmers regarding AMD use and AMDR propagation in rural households. The study was conducted using a pre-tested questionnaire upon 200 respondents with a duration of 5 months in selected areas of Cumilla district, Bangladesh. The correlation analysis showed a significant (p&lt;.01) relationship between farmers’ knowledge and practicing proper administration of drugs in the animal. The sex of the respondents was also found to be correlated with the understanding of Antibiotic Resistance (AR) (p&lt;.01), AR transmission (p&lt;.05), and propagation from livestock to humans (p&lt;.01). Additionally, through the qualitative analysis, we found the powerful impacts of media availability and accessibility, participation in the training program, and good quality education on the improvement of farmers' PPK. Therefore, the government must need to emphasize this topic and educate the farmers about AR to control the spread of AR in order to secure both animal and public health. Asian Australas. J. Biosci. Biotechnol. 2022, 7(2), 57-74

An exploration of midwives' understanding of antibiotic resistance and stewardship in Uganda

Background/Aims A shortage of healthcare professionals has led to task shifting. Antibiotic prescribing is one such task that has been informally shifted to midwives in Uganda. This study aimed to explore the understanding of Ugandan midwives about antibiotic resistance and stewardship and where this knowledge is drawn from. Methods A mixed method approach was used to collect data from 29 midwives working across four healthcare facilities between February 2017 and January 2018. Interviews, observational work and secondary data were analysed to identify themes arising. Results Knowledge held by midwives about antibiotic resistance and antibiotic stewardship was found to be limited. The midwives attributed this to inadequate preparation during their training. Midwives used ‘learning in the field’ as an alternative method to inform their antibiotic prescribing practices. Conclusions Midwives are critical actors in the prevention of antibiotic resistance. Improvements in initial and continuing education are required to adequately prepare midwives for their role as antibiotic stewards.

Omani senior secondary school students' knowledge of and attitudes to antibiotic resistance.

Antibiotic resistance is a worldwide problem that is increasing largely due to the misuse of antibiotics in human health and agriculture. This situation is further exacerbated by a dearth of new antibiotic development, the focus of pharmaceutical companies having shifted to more lucrative treatments for chronic conditions such as elevated blood pressure. To conserve the efficacy of the current crop of antibiotics, it is vital that they are used appropriately by individuals. Effective education may be a means to achieve such appropriate use. This paper reports on a large-scale, mixed methods study, which employed a survey and oral questionnaires, undertaken with senior secondary Omani students. The study explored students’ understanding of antibiotic resistance as well as their attitudes to the issue of antibiotic resistance. The study findings indicated that, although some students had a reasonably clear understanding of antibiotic resistance, many had serious misconceptions that could result in misuse of antibiotics. The article concludes with suggestions for amending secondary school pedagogy in Oman to address the misconceptions.

Synthesis and application of fluorescent teixobactin analogs.

Teixobactin is a promising new antibiotic that kills a spectrum of Gram-positive pathogens that are considered to be urgent threats by the CDC and the WHO. Better understanding of the novel mechanism of action of teixobactin may assist in developing new antibiotics and furthering our understanding of antibiotic resistance. This chapter describes the synthesis and application of fluorescent teixobactin analogs in fluorescence microscopy to study the mode of action of teixobactin. The first part of this chapter describes the synthesis and purification of fluorescent teixobactin analogs using two synthetic approaches. The second part of this chapter describes the application of the fluorescent teixobactin analogs to visualize their interactions with molecular targets in B. subtilis using fluorescence microscopy. The methods described herein provide synthetic access to chemical probes that may help further the understanding of antibiotic resistance.

Knowledge and Expectations on Antibiotic Use Among the General Public in Malaysia: A Nationwide Cross-Sectional Survey.

BackgroundIdentifying knowledge gaps regarding antibiotic use and resistance is important for future interventional strategies. There is limited information on Malaysia’s general public’s knowledge and expectations on antibiotic use.PurposeTo assess the knowledge of antibiotic use and resistance, expectations from antibiotic prescription, and identify inappropriate practices related to antibiotic use among Malaysia’s general public.Materials and MethodsA nationwide cross-sectional survey was conducted among Malaysians aged 18 years and above from each state, from May to November 2019. Participants were recruited via quota sampling, followed by convenient sampling. A validated self-administered questionnaire was used to collect data.ResultsOf the 1971 respondents recruited, 56.6% had engaged in at least one inappropriate practice; particularly, not completing the antibiotic course (48.8%). The mean total knowledge score was 8.57±4.24 (total 20). The majority incorrectly believed that antibiotics work on viral infections (79.1%) and colds and coughs (77.0%). Less than half of them believed that antibiotics could be stopped when symptoms improved (42.8%). Most respondents incorrectly perceived that antibiotic resistance occurs when the body becomes resistant to antibiotics (90.2%) and antibiotic resistance is not an issue in the country (62.9%). More than half the participants expected antibiotics to be prescribed for self-limiting symptoms (fever: 62.9%, sore throat: 57.2%, cold or flu: 50.9%). Respondents with better knowledge were less likely to engage in inappropriate antibiotic use (never engaged: 9.26±4.40 versus had engaged: 8.11±4.00, p<0.001), and expect doctors to discuss with them the need for antibiotics (agree/strongly agree: 9.03±4.25 versus neutral: 6.62±3.91 versus disagree/strongly disagree: 8.29±4.00, p<0.001).ConclusionKnowledge gaps in the role of antibiotics and understanding of antibiotic resistance should be considered whtpen designing future educational strategies for the general public.

Evaluation of Knowledge and Risk Perception about Antibiotic Resistance in Biology and Mathematics Young Students in Nîmes University in France.

In response to the antimicrobial resistance issue, the World Health Organization developed and conducted a survey in 2015 dealing with habits, antibiotic use, awareness of appropriate use and sensitization to the issue of antibacterial resistance. In France, we conducted a similar survey to investigate the use of antibiotics and students’ perceptions of the antibiotic resistance risk. Our results indicated that antibiotics are moderately taken (42% in the last six months), but mistakes remain in appropriate practices and knowledge. Many people still believe that the body develops resistance to antibiotics and 24% responded that antibiotics can be stopped before the end of the treatment if they feel better. Furthermore, only 14% said antibiotics could be used to treat gonorrhea while 57% indicated that influenza could be treated with antibiotics. We looked at risk perception as well, and noticed that students in biology were more aware of risk (mean score = 48.87) and health consequences (mean score = 40.33) than mathematics students (mean score = 44.11 and 37.44). They were more aware of the threat, had a better understanding of antibiotic resistance and their denial of this risk was less significant (mean score = 27.04 against 23.81). However, the importance of providing a minimum level of knowledge to young students has been emphasized, regardless of the field of expertise.

Characteristics of colistin-resistant Escherichia coli from pig farms in Central China

The emergence and dissemination of colistin resistance in Enterobacteriaceae mediated by plasmid-borne mcr genes in recent years now pose a threat to public health. In this study, we isolated and characterized colistin-resistant and/or mcr-positive E. coli from pig farms in Central China. Between 2018 and 2019, 594 samples were collected and recovered 445 E. coli isolates. Among them, 33 with colistin resistance phenotypes and 37 that were positive for mcr genes were identified, including 34 positive for mcr-1, one positive for mcr-3, and two positive for both mcr-1 and mcr-3. An insertion of nine bases (“CTGGATACG”) into mcr-1 in four mcr-positive isolates led to gene dysfunction, and therefore did not confer the colistin resistance phenotype. Antimicrobial susceptibility testing revealed that 37 mcr-positive isolates showed severe drug resistance profiles, as 50% of them were resistant to 20 types of antibiotics. Multilocus sequence typing revealed a heterogeneous group of sequence types in mcr-positive isolates, among which ST10 (5/37), ST156 (5/37), and ST617 (4/37) were the predominant types. Plasmid conjugation assays showed that mcr-carrying plasmids of 25 mcr-positive isolates were conjugated with E. coli recipient, with conjugation frequencies ranging from 1.7 × 10-6 to 4.1 × 10-3 per recipient. Conjugation of these mcr genes conferred a colistin resistance phenotype upon the recipient bacterium. PCR typing of plasmids harbored in the 25 transconjugants determined six types of plasmid replicons, including IncX4 (14/25), FrepB (4/25), IncI2 (3/25), IncHI2 (2/25), FIB (1/25), and IncI1 (1/25). This study contributes to the current understanding of antibiotic resistance and molecular characteristics of colistin-resistant E. coli in pig farms.

Tanzanian primary healthcare workers\u2019 experiences of antibiotic prescription and understanding of antibiotic resistance in common childhood infections: a qualitative phenomenographic study

BackgroundAntibiotic resistance is a threat to global child health. Primary healthcare workers play a key role in antibiotic stewardship in the community, but few studies in low-income countries have described their experiences of initiating antibiotic treatment in children. Thus, the present study aimed to describe primary healthcare workers’ experiences of antibiotic prescription for children under 5 years of age and their conceptions of antibiotic resistance in Northern Tanzania.MethodsA qualitative study involving individual in-depth interviews with 20 prescribing primary healthcare workers in Moshi urban and rural districts, Northern Tanzania, was performed in 2019. Interviews were transcribed verbatim, translated from Kiswahili into English and analysed according to the phenomenographic approach.FindingsFour conceptual themes emerged during the analysis; conceptions in relation to the prescriber, the mother and child, other healthcare actors and in relation to outcome. The healthcare workers relied mainly on clinical examination and medical history provided by the mother to determine the need for antibiotics. Confidence in giving advice concerning non-antibiotic treatment varied among the participants and expectations of antibiotic treatment were perceived to be common among the mothers. Antibiotic resistance was mainly perceived as a problem for the individual patient who was misusing the antibiotics.ConclusionsTo increase rational antibiotic prescription, an awareness needs to be raised among Tanzanian primary healthcare workers of the threat of antibiotic resistance, not only to a few individuals, but to public health. Guidelines on childhood illnesses should be updated with advice concerning symptomatic treatment when antibiotics are not necessary, to support rational prescribing practices and promote trust in the clinician and mother relationship.

The occurrence of antibiotic resistance genes in the microbiota of yak, beef and dairy cattle characterized by a metagenomic approach

Drug resistance has been partly driven by the overuse of antimicrobials in agricultural animal feed. Better understanding of antibiotic resistance in bovine gut is needed to assess its potential effects based on metagenomic approach and analysis. In this study, we collected 40 fecal samples to explore drug resistance derived from antibiotic use in the bacterial community by an analysis of the diversities and differences of antibiotic-resistant genes (ARGs) in the gut microbiota from yak, beef, and dairy cattle. Overall, 1688 genes were annotated, including 734 ARG subtypes. The ARGs were related to tetracyclines, quinolones, β-lactam, and aminoglycosides, in accordance with the antibiotics widely used in the clinic for humans or animals. The emergence, prevalence, and differences in resistance genes in the intestines of yaks, beef, and dairy cattle may be caused by the selective pressure of different feeding patterns, where yaks were raised without antibiotics for growth promotion. In addition, the abundance of ARGs in yak was lower than in beef and dairy cattle, whereas the abundance of integron, a kind of mobile genetic elements (MGEs) was higher in yaks than those in beef and dairy cattle. Furthermore, the results of this study could provide the basis for a comprehensive profile of various ARGs among yak, beef, and dairy cattle in future.

The Not-So-Strange Case of Dr. Jekyll and Mr. Hyde in Antibiotic Research: An Interdisciplinary Opportunity.

Literary-rhetorical devices like figurative language and analogy can help explain concepts that exceed our capacity to grasp intuitively. It is not surprising these devices are used to discuss virulence, pathogenesis, and antibiotics. Allusions to Robert Louis Stevenson’s Strange Case of Dr. Jekyll and Mr. Hyde seem to be used with particular frequency in research pertaining to pathogens, especially in studies contemporary with our evolving understanding of antibiotic resistance. More recent references to the text have appeared in research parsing definitions of virulence and acknowledging the role of anti-virulence in future therapeutics. While it is obvious that scientists invoke Stevenson’s story for stylistic purposes, its use could go beyond the stylistic—and might even generate rhetorical and imaginative possibilities for framing research. This perspective discusses the first published allusion to Jekyll and Hyde in reference to virulence and pathogenesis; comments on a select number of specific instances of Jekyll and Hyde in contemporary scientific literature; briefly contextualizes the novel; and concludes with the implications of a more productive engagement with humanistic disciplines in the face of antibiotic resistance.

Antimicrobial resistance screening and profiles: a glimpse from the South African perspective.

According to the Centre for Disease Dynamics Economics and Policy, South Africa represents a paradox of antibiotic management similar to other developing countries, with both overuse and underuse (resulting from lack of access) of antibiotics. In addition, wastewater reuse may contribute towards antibiotic resistance through selective pressure that increases resistance in native bacteria and on clinically relevant bacteria, increasing resistance profiles of the common pathogens. Sediments of surface water bodies and wastewater sludge provide a place where antibiotic resistance genes are transferred to other bacteria. Crop irrigation is thought to be a potential source of exposure to antibiotic-resistant bacteria through the transfer from the water or sludge into crops. The objectives of this study were to examine the antibiotic-resistance profiles of Escherishia coli from three agricultural locations in the Western Cape, South Africa. Using a classical microbiology culture approach, the resistance profiles of E. coli species isolated from river water and sediments, farm dams and their sediments and a passive algal wastewater treatment ponds and sediment used for crop irrigation were assessed for resistance to 13 commonly used antibiotics. Randomly selected E. coli isolates from the sediment and water were tested for resistance. 100% of E. coli isolates were resistant to sulphamethoxazole, highlighting its relevance in the South African context. In river water and farm dam samples, only the E. coli isolated from sediment were found to be resistant to fluoroquinolone or fluorifenicol. In the wastewater treatment ponds, the resistance profiles of E. coli isolated from sediments differed from those isolated from effluent, with 90% of the effluent isolates being resistant to ampicillin. Isolates from the sediment were less resistant (40%) to ampicillin, whereas all the isolates from the pond water and sediment samples were resistant to sulphamethoxazole. These results illustrate the importance of developing a better understanding of antibiotic resistance in agriculture and wastewater scenarios to ensure remedial measures take place where the greatest benefit can be realised especially in countries with limited financial and infrastructural resources. Moreover, the potential for passive algal treatment as an effective, feasible alternative for wastewater treatment is highlighted, with comparable resistance profiles and a reducing overall resistance in the sediment samples.

Survey of selected antibiotic resistance genes in agricultural and non-agricultural soils in south-central Idaho.

Improving our understanding of antibiotic resistance in soils is important for the protection of human, animal and ecological health. In south-central Idaho, antibiotic resistance genes (ARGs) [blaCTX-M-1, erm(B), sul1, tet(B), tet(M) and tet(X)] and a class 1 integron-integrase gene (intI1) were quantified in agricultural and non-agricultural soils (96 total sites) under various land use practices (cropland, forestland, inactive cropland, pastureland, rangeland, recreational, residential). We hypothesized that gene occurrence and abundance would be greater in intensively managed agricultural soils. The ARGs (except blaCTX-M-1) and intI1 gene were detected in many of the soils (15 to 58 out of 96 samples), with sul1 and intI1 being detected the most frequently (60% of samples). All of the genes were detected more frequently in the cropland soils (46 sites) and at statistically greater relative abundances (per 16S rRNA gene) than in soils from the other land use categories. When the cropland gene data was separated by sites that had received dairy manure, dairy wastewater, and/or biosolids (27 sites), it was revealed that the genes [except tet(B)] were found at statistically greater abundances (7- to 22-fold higher on average) than in soils that were not treated. The results from this study provide convincing evidence that manure/biosolids use in Idaho cropland soils increases the expansion of antibiotic resistance-related determinants.

Parents' perceptions of antibiotic use and antibiotic resistance (PAUSE): a qualitative interview study.

BackgroundThere remains public misconception about antibiotic use and resistance. Preschool children are at particular risk of receiving unnecessary antibiotics because they commonly present in primary care and many childhood infections are self-limiting.ObjectivesThe aim of our study was to explore parents’ perceptions and understanding of antibiotic use and resistance in the context of their young child with an acute respiratory tract infection (RTI) and to explore strategies parents would find acceptable to minimize antibiotic resistance for their families.MethodsSemi-structured interviews were conducted with 23 parents of preschool children who recently had an acute RTI across greater Oxfordshire, UK (2016–17 winter). We explored their beliefs about antibiotics, understanding of antibiotic resistance and views on current public antibiotic awareness campaigns at the time. Thematic analysis was used to analyse the data.ResultsParents had a sense of optimism and considered their families to be at low risk of antibiotic resistance because their families were ‘low users’ of antibiotics. Very few parents considered antibiotic resistance as a possible harm of antibiotics. Parents thought they were acting morally responsibly by following campaign messages. They wanted future campaigns to have a relevant, accessible message for families about the impact of antibiotic resistance.ConclusionsFuture communication about the potential impact of unnecessary antibiotic use and antibiotic resistance needs to focus on outcomes that parents of young children can relate to (e.g. infection recurrence) and in a format that parents will engage with (e.g. face-to-face dissemination at playgroups and parent/child community events) to make a more informed decision about the risks and benefits of antibiotics for their child.

Exploring patients’ understanding of antibiotic resistance and how this may influence attitudes towards antibiotic use for acute respiratory infections: a qualitative study in Australian general practice

ObjectivesTo explore patients’ or parents of child patients’ understanding of antibiotic resistance and aspects of resistance such as resistance reversibility and its spread among those in close proximity, along with...