Are sepsis awareness and antimicrobial stewardship competing goals? A newsprint content analysis: Shona Hilton

Antimicrobial resistance has emerged as a major threat to public health that is predicted to be responsible for ten million deaths per annum by 2050. One key driver is inappropriate use of antibiotics in managing minor illnesses that would resolve spontaneously without drug treatment. Reduction in unnecessary prescribing is a vital component of antimicrobial stewardship but is complicated by a recent drive to improve recognition of sepsis, a serious consequence of untreated bacterial infection associated with high mortality. We explored similarities and differences in how the drivers and solutions of antimicrobial resistance and sepsis are framed in newsprint media. Quantitative analysis was conducted on the content of 300 articles about sepsis and 162 articles about antimicrobial resistance published in 11 UK national newspapers searching on all available dates up to 31st December 2016. Thematic categories were compared using Chi-square tests of association, with statistical significance set at p < 0.01. Articles about sepsis were more likely to be personalised with case histories, often involving children or high profile individuals, and to identify failings within local healthcare settings. For sepsis, the main solution was presented as increased awareness to allow early recognition and antimicrobial treatment. In contrast, antimicrobial resistance was presented as a global problem resulting from harmful collective actions of the healthcare, pharmaceutical and agricultural sectors whose solutions are technical and systemic in nature, and largely out with the control of the individual. Exposure to news stories about sepsis has the potential to alter public awareness and perception of risks associated with minor illness. This may impact on expectations of receiving antimicrobial treatment, with implications for antimicrobial stewardship.

Key messages:

Antimicrobial resistance is rarely presented in relation to its impact on individuals but as a global issue whose solutions lie with policymakers and are out with the control of the individual.

In contrast, sepsis is framed as a health issue associated with high costs to the individual that can be avoided by greater awareness, with potential implications for antimicrobial stewardship.