Antibiotic resistance has a language barrier

Antimicrobial resistance, antibiotic stewardship, AMR, DRI, war on superbugs...

Detail from a map of the world with each area made up of human tissue relating to the main health problems in that area

Credit: Odra Noel, Wellcome Images

International experts, including Wellcome, are calling for standardised terminology to discuss drug-resistant infections that can be understood in different languages and countries.

Wellcome is joining international experts to call for a review of the global language used to discuss the problem of pathogens resistant to available drugs.

In a joint comment published in Nature, the five authors, from South Africa, Switzerland, France and the UK, say failure to use simple, clear and consistent language risks undermining the global response to this urgent health threat.

They say a review is essential to address misunderstandings and improve awareness among the public and policymakers.

Co-author Tim Jinks, Head of Wellcome's Drug-resistant Infections Programme, says: "It is vital that the problem is communicated in a way that everyone can understand and helps people to engage in meaningful discussions about solutions.

"The confusion created by the different terms currently being used is preventing understanding that this is a health problem now, and what governments, health leaders and individuals need do to address it."

The group calls for particular focus on three areas of language:

  • Drug-resistant infections – rather than ‘antimicrobial resistance’ – should be the overarching term in English for infections caused by bugs resistant to treatment, including antibiotics.
  • Stewardship – this must be clearly identified as the strategy ensuring appropriate use of antibiotics by every individual prescriber in human and animal health, whether in institutions or communities, practices or farms. The enablers of stewardship at a national and global level must be better defined and understood.
  • War – the rhetoric pitching humans in a fight against bacteria requires more nuanced and balanced use, to take into account humans’ ecological relationship with bacteria. Combat references fail to recognise that the more we ‘attack’, the more we interrupt the vital role bacteria play in human immunity, digestion and gut health.

The authors are calling on a newly formed UN taskforce to prioritise action to ensure global terminology is reviewed.

Lead author Marc Mendelson, Professor of Infectious Diseases and Head of Infectious Diseases and HIV Medicine at Groote Schuur Hospital, University of Cape Town, says: "With increasing involvement of non-clinical specialists and the public in a multidisciplinary response to the global health crisis of bacterial resistance to antibiotics, we need standardised, balanced and clearly understood terminology.

"Such terminology must be understood across language, geographic, disciplinary and social settings, and will require a programme of research to optimise its use."

A 2015 survey by the World Health Organization across 12 countries highlighted the lack of familiarity with the language of antibiotic resistance.

A study by Wellcome Trust in the same year also found people in the UK have little awareness of what ‘antibiotic resistance’ means and how it might affect their health.

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