Terminology in focus
Drug-resistant infection: The authors propose this be the overarching term used to describe infections caused by organisms that are resistant to treatment. More specific words such as ‘antibiotic’ or “antifungal’ should be used in preference to ‘antimicrobial’ when referring to medicines against a specific type of organism, they suggest..
Stewardship: This term refers to to how the appropriate use of antibiotics can maximise both their current effects and the chances of their being available for future generations, the authors say, but they warn it is used too narrowly. While most people use it to describe the actions of physicians and pharmacists, it could refer to six endeavours – individual, multidisciplinary, hospital, community, national and global actions.
The War: The authors write that much of the rhetoric around drug resistance has pitched humans in a fight against bacteria with people referring to ‘the war against superbugs’, or the ‘fight against AMR’. In the pursuit of an enemy, responsibility for the increase of antibiotic-resistant bacteria in humans is often placed at the door of animal-health professionals, the livestock industry, farmers and veterinary surgeons, they say.
“This blame narrative is unhelpful,” they write, adding that the predominant driver of antibiotic resistance in humans is the intense pressure exerted by the misuse and overuse of antibiotics in people.
“War and threat were once potent rallying calls. But a more nuanced, balanced, standardised vocabulary is now needed — one that takes ecological ‘balance into account,” they argue.