“I just know when I have been suffering for two or three weeks that I need more than Lemsip,” said one woman. “They’re stronger than anything else; it has to be antibiotics at this point.”
This makes life very hard for doctors. Patients will kick up a fuss if they are denied prescriptions, or exaggerate the nature of their symptoms to secure one. But very few of them self-identify as someone who badgers their doctors for antibiotics. They feel they know their own bodies, so they only ask for antibiotics when they genuinely need them. And a prescription reassures and vindicates them—it’s proof that they are genuinely ill, and that their disease is treatable.
Their understanding of antibiotic resistance is even worse. The researchers asked them about it and got blank faces in response. When probed—and here’s the bit that really shocked me—almost everyone assumed that it’s the person who becomes resistant to antibiotics, not the microbes. You take enough of something, they reasoned, and your body gets used to it and builds up a tolerance. It’s such an intuitive idea that even after they read simple descriptions that explained how bacteria become resistant, they reverted to the resistant-patient idea.
As misunderstandings go, this is a pretty serious one, because some people reasoned that if they don’t finish their courses, they’re less likely to become “resistant.” Ironically, that decision could increase the odds of developing an actual drug-resistant infection by leaving a pool of surviving microbes that have experienced and withstood the antibiotics.
The fault, arguably, is on us—science journalists, scientists, doctors, communicators, and everyone else who’s beating the drum about this impending threat. We’re not doing it very well.
Doom-laden statements don’t work; the interviewees were far too desensitized to messages of medical doom, and quickly dismissed them as media scaremongering. The term “superbugs” felt abstract and confusing; it made them think about swine flu or Ebola—threats that either seemed to pass with little incident, or happened to people living far away. Statistics about drug-resistant infections causing millions of deaths were hard to grasp, and provoked skepticism rather than concern. “Where do they pluck these numbers from?” one person asked.
The dire warnings and grandiose (but arcane) language only served to make people think of antibiotic resistance as an irrelevant, sensationalized problem that’s unlikely to affect them. Even if they accepted that the problem is real, they were confident that scientists would sort it out. Why engage with it, especially if they couldn’t do anything about it? (Remember that most of them didn’t see their own antibiotic-seeking behavior as anything out of the ordinary.)
A few messages, however, resonated more strongly. When they heard that everyday problems like cuts and scratches, or routine operations like hip replacements and C-sections, could become deadly if infected by drug-resistant microbes, they took notice. These everyday effects, which Maryn McKenna describes beautifully in her TED talk, really hit home. “This is going to affect us all,” said one couple. “My dad had a hip replacement and infection.”