Antibiotic resistance

Antibiotic resistance

Antimicrobial resistance (AMR) is one of the biggest threats to public health with latest data confirming that across the European Union the number of patients infected by resistant bacteria is increasing and that antibiotic resistance is a major threat. It is therefore vital that awareness of this issue is raised and that antibiotics are used in a prudent manner to help slow down resistance and keep antibiotics effective for the use of future generations.

To raise awareness among health professionals and the public of AMR and appropriate prescribing, a European Antibiotic Awareness Day (EAAD) has been running each November since 2008. In 2014, the UK’s Antibiotic Guardian campaign was launched and in 2015, the World Health Organization (WHO) launched World Antibiotic Awareness Week (WAAW) to increase awareness around the world.

The dates for these awareness campaigns in 2019 are to be finalised.

Antibiotic Guardian is an ongoing campaign. 

Antibiotic Guardian campaign

Antibiotic Guardian is a UK-wide campaign which aims to improve behaviours around antibiotic prescribing and use by increasing knowledge about antibiotic use. The campaign supports the UK 5 Year Antimicrobial Resistance Strategy 2013 to 2018, which sets out actions to slow the development and spread of AMR.

The campaign, which takes a One Health approach, calls on everyone in the UK (the public, animal and human healthcare communities) to become Antibiotic Guardians by choosing one simple pledge about how they will make better use of these vital medicines.

Public Health England (PHE) is encouraging pharmacy teams to get involved and is hoping to achieve the following:

  • to double the number of pharmacy teams making an Antibiotic Guardian pledge to 10,000 – pharmacy teams can make their pledge on the Antibiotic Guardian website;
  • for 50% of the members of the public who become Antibiotic Guardians during 2016/17 to find out about this via community pharmacy; and
  • for at least 10% of community pharmacy teams to register to promote antibiotic awareness and the Antibiotic Guardian campaign during WAAW.

Pharmacy teams can register their community pharmacy premises to lead promotional activities for EAAD, WAAW and the Antibiotic Guardian campaign 2016. PHE has produced resources to support local and social media campaigns, which are available to download from GOV.UK

Antibiotic Guardian roadshows

To ensure that the information and knowledge on Antibiotic Stewardship and Infection Prevention and Control are disseminated to those practising healthcare across the nation, PHE run educational workshops to provide guidance, resources and information for practitioners on topics associated with antibiotic awareness.

These events give the opportunity to understand how you and your organisation could support combat the global challenge faced by antibiotic resistance whilst gaining advice, support and resources to inform patients and staff.

Registration of planned activities to raise awareness

In 2016 PHE wrote to NHS, universities and professional organisations to inform them about EAAD, WAAW and the Antibiotic Campaign and invited organisations to register their support for these. This enabled PHE to coordinate activities across the UK.

Resources for local and social media campaign

An Antibiotic Guardian campaign poster, which was produced by PHE was sent out to all community pharmacies in England in PSNC’s October 2016 Community Pharmacy News (CPN). This poster (supported by PSNC, the Royal Pharmaceutical Society, Pharmacy Voice, the Centre for Pharmacy Postgraduate Education, the Association of Pharmacy Technicians UK and the British Pharmaceutical Students’ Association) is intended to help pharmacy teams increase awareness of the Antibiotic Guardian campaign amongst their patients.

PHE has also created a number of resources to support local and social media campaigns including:

  • key messages on antibiotic use – guidance on how to use antibiotics responsibly for patients, animal keepers and pet owners. PHE has also produced a short video to help explain the problem of antibiotic resistance;
  • resources toolkit for healthcare professionals in England – provides guidance on how to use antibiotic awareness resources to support the Antibiotic Guardian campaign and local initiatives;
  • quizzes and crosswords – downloadable documents on antibiotic resistance, which can be used by the public and healthcare professionals;
  • posters and leaflets – downloadable materials to support antibiotic awareness campaigns in the UK;
  • treating your infection leaflets – downloadable leaflets to be shared with patients by out of hour prescribers and community pharmacists during consultations advising on infection self-care;
  • Antibiotic Guardian email signature – Guidance on how to add this can be found in the resources toolkit (page 39); and
  • Pack of infographics – to tell the story of who is prescribing antibiotics, how many and what type are being prescribed, and how to encourage responsible use of the drugs.

Certain printed resources are also available to order from the NHS Supply Chain including posters, leaflets, badges, magnets, stickers and pens. Full details of the items that were available including  prices is available on the EAAD and Antibiotic Guardian NHS Supply Chain Printing document

Social media

PHE has created an online quiz which can easily be shared via email or via social media The results of this quiz were used in 2015/16 to help assess awareness on antibiotic resistance across the UK.

The blog ‘10 reasons you should be worried about antibiotic resistance can also be shared in this way.

Antibiotic Guardian images and messages for use on social media can be obtained by emailing to request a social media pack. Example social media messages for the campaign can also be found in the Resources toolkit (page 16).


If you use Twitter to promote the campaign, remember to use the #AntibioticGuardian hashtag.

If you are on Twitter and are an Antibiotic Guardian you can also add a Twibbon to your profile picture to show your support for the campaign. 

Continuing Professional Development (CPD)


In 2014, the Centre for Pharmacy Postgraduate Education (CPPE) ran a ‘Use antibacterials wisely’ campaign, which was recreated into a leaflet for 2015/16 outlining some challenges to increase awareness of antibacterial resistance.

Distance learning

The CPPE distance learning programme ‘Antibacterial resistance – a global threat to public health’ is also available and can be downloaded as a PDF.

Online learning

  • CPPE has a learning topic on antibacterials on which is available for everyone working in community pharmacy.
  • NICE has launched an online antimicrobial stewardship learning tool, developed by CPPE, that uses interactive activities and case studies to support implementation of NICE guidance.
  • The e-learning programme Reducing Antimicrobial Resistance: An Introduction provides an overview of how to tackle AMR, key facts about AMR and describes the important role everyone working in a health and social care environment has in tackling it.
  • PHE and the British Society for Antimicrobial Chemotherapy (BSAC) have worked with primary care colleagues to develop a series of seven free TARGET antibiotics webinars. Originally hosted as live webinars, these learning modules are now available as un-facilitated learning courses, each containing presentations, recorded panel discussions and a host of referenced material and learning resources.
  • There is also a TARGET antibiotics toolkit, which is aimed at for primary care colleagues. The toolkit includes training resources as well as information leaflets to provide to patients.
  • Future Learn has a free six-week online course on Antimicrobial Stewardship: Managing Antibiotic Resistance.

Other resources

Other CPD resources on antimicrobial prescribing can be found on the GOV.UK website. 

Related resources

  • PSNC – National audit data reiterates community pharmacy’s role in medicines optimisation (January 2017)
  • The Antibiotic resistance: multi-country public awareness survey, commissioned by WHO, asked 10,000 members of the public across 12 countries about their use of antibiotics, knowledge of antibiotics and of antibiotic resistance.
    The survey reveals common misconceptions and misunderstandings including the belief that individuals are not at risk of a drug-resistant infection if they personally take their antibiotics as prescribed.
  • Specialist Pharmacy Service – NICE Bites – Antimicrobial stewardship: changing risk-related behaviours in the general population.
    NICE Bites is a monthly prescribing bulletin from the North West Medicines Information Centre which summarises key prescribing points from NICE guidance.  Sections covered include; managing self-limiting infections, when antimicrobials are prescribed/supplied, general advice, self-care, hand-washing, and use of antimicrobial medicines in the following settings – primary care, community pharmacy teams, CCGs, public health teams, pre-school settings, schools, educational and residential settings for young people.
  • PHE has published their second edition of Health Matters, which is focused on AMR. The resource entitled Tackling antimicrobial resistance sets out the scale of the problem and how healthcare professionals, and those working in local authorities can reduce the levels of antibiotic prescribing.
  • PHE has published AMR local indicators – These profiles contain a selection of data on AMR and Healthcare-associated infection (HCAI) related indicators. These data include trends for antibiotic prescribing in primary care and HCAI in acute NHS Trusts.

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