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Guidance

AMR engagement guide: actions to prevent antimicrobial resistance

Published 3 September 2026

© Crown copyright 2026

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This publication is available at https://www.gov.uk/government/publications/engagement-guide-for-infection-and-antimicrobial-resistance-amr/amr-engagement-guide-actions-to-prevent-antimicrobial-resistance

This section is designed to explain the practical actions that individuals, families and communities can take to help prevent antimicrobial resistance (AMR) and why these actions matter. It also includes the role of research and global actions. It provides clear guidance that can be used in conversations with patients, families, animal owners, students, and the wider public, as well as across healthcare, veterinary, farming, community and educational settings.

By highlighting simple daily behaviours such as infection prevention, responsible use of antibiotics, safe disposal of medicines, and open communication with healthcare professionals, this section helps people understand how their choices contribute to tackling AMR. It also explains how to support public involvement through resources, training opportunities and awareness campaigns.

Individual and group actions

Everyone has a role to play in slowing the development and spread of AMR.AMR is a serious challenge, but with awareness and responsibility, individual and collective action, we can protect ourselves, our communities, and future generations.

Below describes suggested actions individuals and groups can take to help prevent the spread of AMR. Suggested actions to reduce AMR – adapted from Antibiotic Guardian pledges.

General public

Preventing infection

Actions:

  • consider any vaccines offered by the NHS and ensure vaccine record is up to date
  • use tissues (catch it, bin it, kill it) and wash hands to prevent spreading infections
  • practise good kitchen hygiene when preparing food
  • ensure food is stored and prepared correctly, considering the 4 C’s (cleaning, cooking, chilling and avoiding cross-contamination)
  • practise good oral and dental hygiene
  • become involved in joint projects with scientists (citizen science projects) and advocacy groups focused on AMR
  • practice safe sexual health by taking steps to prevent sexually transmitted infections (such as use of barrier protection)
  • individuals who are more vulnerable to infections (such as those with weakened immune systems) should follow enhanced protective measures, such as keeping up to date with all recommended vaccines, reducing exposure to crowded indoor spaces, practicing good hand hygiene, and seeking early medical advice when unwell

Managing infection

Actions:

  • avoid requesting antibiotics for viral infections like colds and flu
  • only use antibiotics for the illness they were prescribed for, never use them for a different illness. Take for the duration advised
  • take any unused antibiotics to your local pharmacy for safe disposal
  • never share or save antibiotics
  • seek advice from health care professionals, or NHS (England), NHSInform (Scotland), NHS 111 (Wales), Northern Ireland Direct and use self-care for mild illnesses, including wound care and disinfection
  • when consulting a health professional, notify them if you have had antibiotics recently or have a history of a resistant infection
  • notify a health professional if your infection doesn’t seem to be responding to an antibiotic

Pet owners and animal keepers

Preventing infection

Actions:

  • maintain hand hygiene to help prevent transmission between animals and humans and vice versa
  • if feeding raw pet food, then understand the risks and ensure the advice from the Food Standards Agency on hygiene as well as safe storage and handling are followed, see Raw pet food
  • keep animals healthy to avoid infections
  • keep vaccinations up to date

Managing infection

Actions:

  • store antibiotics correctly in accordance with your vet’s advice
  • follow vet advice and complete prescribed antibiotic courses
  • do not reuse antibiotics prescribed by the vet on subsequent illnesses or for other animals or pets
  • return unused antibiotics back to the vet for safe disposal

Farmers and livestock keepers

Preventing infection

Actions:

  • work with your veterinary surgeon to keep an up-to-date Animal Health Plan that is focused on disease prevention
  • maintain good nutrition, husbandry, biosecurity, vaccinations and worming (where needed), regular health monitoring, and have regular veterinary health checks

Managing infection

Actions:

  • review and discuss antibiotic use on the farm with your vet and look for ways to reduce, refine or replace use
  • ensure you know how to correctly handle and administer antibiotics supplied to the farm
  • record antibiotics use data and share with industry for national reporting
  • use antibiotics only as prescribed by your vet and observe withdrawal periods
  • store antibiotics correctly and dispose of unused antibiotics via the veterinary practice or licensed waste contractor, in line with environmental regulations
  • for antibiotics administered in-feed or in-water, monitor animals to ensure they are eating and drinking properly and therefore receiving the correct dose
  • for animals receiving antibiotics, monitor them carefully to assess response to treatment and contact your vet if there are any concerns

Human healthcare workers

Preventing infection

Actions:

  • promote infection prevention, including hand hygiene, cough etiquette, oral and dental hygiene, food hygiene and vaccination to reduce antibiotic demand
  • benchmark prescribing data with peers using local or national databases and develop quality improvement action plans where required such as:
  • ensure easy access to local and national antibiotic guidance for all prescribers
  • ensure accurate documentation of antibiotic prescribing for safe continuity of care
  • promote nationally or locally agreed messages to raise awareness of IPC and its role in AMR
  • Ensure good urinary catheter, intravenous line and wound care

Managing infection

Actions:

Veterinary prescribers

Preventing infection

Actions:

  • report treatment failures to the Veterinary Medicines Directorate
  • minimise the spread of bacteria between animals within the practice by maintaining infection prevention and control
  • work with farm clients to produce a clear animal health plan to reduce the inappropriate use of antibiotics in farm animals and focus on disease prevention
  • only use antibiotics for preventative use in exceptional circumstances, where the risk of disease spread is very high and the consequences of not prescribing the product are likely to be severe

Managing infection

Actions:

  • antibiotics can only be prescribed following a clinical assessment of the animals under the vet’s care, to ensure there is enough information to diagnose and prescribe safely and effectively
  • avoid unnecessary use and only use Highest Priority Critically Important antibiotics as a last resort, where no clinical effective lower risk antibiotics exist
  • follow product instructions (including using the correct dose and duration of treatment) and storage advice
  • ensure clients have and understand all the information they need to administer the antibiotic correctly
  • promote a culture of responsible use of antibiotics at work and within the professional network

Educators and scientists

Preventing infection

Actions:

  • use the e-Bug website resources to develop lesson plans and presentations for schools
  • ensure AMR is included within the institution curriculum
  • encourage completion of the Antibiotic Guardian online quiz and encourage students to choose their own pledge and become Antibiotic Guardians
  • attend conferences, lectures or undertake self-led learning
  • participate in collaborative AMR research

The role of research

Public engagement plays a vital role in supporting the top 10 research priorities set out in the UK’s Confronting Antimicrobial Resistance 2024 to 2029 5 year Action Plan. The plan highlights research needs across surveillance, antimicrobial stewardship, infection prevention, diagnostics, vaccines, and health inequalities, areas where public awareness, trust, and involvement directly influence impact. Meaningful engagement can help generate better data for surveillance, improve adherence to stewardship messages, support uptake of vaccines and diagnostic tests, and shape research that reflects real community needs and lived experiences. In Scotland, the One Health Register (SOHAR) brings together AMR-related research involving Scottish researchers and organisations.

Research priorities are also engagement priorities, because progress in AMR research requires an informed, empowered public that understands the importance of reducing antimicrobial use, preventing infections, and supporting innovation that protects both current and future health.

How to influence public awareness and behaviour on AMR is one of the 10 priority questions and examples of questions are:

  • what are the current patterns of prescriber and patient knowledge, attitudes and practices relating to antibiotic prescription and use across population groups and geographic locations?

  • what are the most important messages related to AMR to communicate to the public, including risks of exposure to resistant pathogens through antibiotic use and transmission risk between humans, companion animals, water and recreational activities?

  • what are the most effective and cost-effective interventions to build public trust, reduce misinformation, communicate risks related to antibiotic exposure, communicate methods of self-care and reduce antibiotic seeking behaviours across population groups?

Driving global action

Collaboration at high level international forums is an important engagement activity as specified in the NAP because these meetings help elevate AMR on the global agenda and encourage countries to work together. By taking part in events like the UN General Assembly and other international groups, the UK can push for strong political commitment, support the development of independent scientific advice, and help improve global funding and accountability for AMR. These forums also give the UK a chance to share learning, coordinate actions with other countries, and work closely with organisations like the WHO, FAO, WOAH and UNEP to maintain AMR as a shared global priority. One such example is the Quadripartite Antimicrobial Resistance Multi-Stakeholder Partnership Platform. This aims to bring together all sectors and perspectives using a One Health approach, to create a shared vision responding to the need to improve co-ordination of efforts by stakeholders.

Case study: Responsible Use of Medicines in Agriculture Alliance (RUMA) Agriculture Targets

Since 2014, antibiotic use in the food-producing animal sectors has reduced by 57%. This has been achieved through strong engagement with the livestock sector, including the creation of antibiotic usage targets in 2017, coordinated by RUMA. A vet and farmer from each major livestock sector (beef, dairy, egg, fish, gamebird, pig, poultry meat and sheep sector) helped develop these targets by working with the wider industry through antibiotic stewardship groups. Setting sector specific targets ensured they were relevant, encouraged accountability, and supported buy-in. The targets focus on preventing disease through measures such as vaccination, housing, genetics, nutrition and biosecurity, and on reducing inappropriate antibiotic use while protecting animal welfare.

Building on this success, the dog and cat sectors introduced their own targets in 2025, coordinated by the RUMA Companion Animal and Equine group. Although antibiotic use in companion animals has fallen over the past decade, evidence shows they are still sometimes used for conditions where they may not be needed. The new targets, along with clearer condition-specific guidance, aim to maintain progress and support consistent, responsible antibiotic use.

See the RUMA Target Task Force Reports.

Case study: Royal College of Veterinary Surgeons (RCVS) Knowledge Awards Success Stories

The Antimicrobial Stewardship category of the RCVS Knowledge Awards recognises the commitment of UK veterinary teams to responsible antibiotic use.

In 2024, the winning team, CVS South 4 Region, used the ‘Plan, Prevent, Protect’ framework to rethink their prescribing practices and achieved a 70% reduction in the use of long-acting antibiotics for cat bite wounds and superficial skin infections, without affecting patient welfare.

In 2025, Animal Trust Dewsbury CIC were recognised for reducing their use of highest priority critically important antibiotics (HP-CIAs). By increasing culture and sensitivity testing, improving stock control, and holding team led meetings, they cut HP-CIA prescriptions from 3% to 0.46% of consultations and stopped stocking several HP-CIAs, without compromising welfare.

Other highly commended teams demonstrated practical improvements in areas such as dental and surgical procedures and managing diarrhoea in dogs. These examples show how veterinary teams are applying stewardship principles through small, steady changes that collectively strengthen responsible antibiotic use across the profession.

Case study: NHS Scotland national antibiotic indicators

In December 2025, the Scottish Government issued a Directors Letter signed by 8 chief and senior officers endorsing new antibiotic prescribing indicators for NHS Boards in Scotland. Co-designed with the Scottish Antimicrobial Prescribing Group, antimicrobial management teams and national stakeholders these provide ambitious but achievable measures to support the delivery of the UK 5-year action plan for antimicrobial-resistance 2024 to 2029 prescribing targets 4a and 4b. The indicators focus on improving prescribing quality by promoting shorter durations of therapy, use of recommended first-line antibiotics, recording indication and reducing unwarranted variation between NHS Boards. They also include an indicator for dental practice for the first time.

These indicators provide an easily measurable consistent framework to support local antimicrobial stewardship interventions and initiatives and a standardised approach to antimicrobial stewardship across Scotland. They allow benchmarking, support improved prescribing practices, and align local delivery with national AMR objectives. Delivery is led locally by multidisciplinary Antimicrobial Management Teams, with national coordination provided by Scottish Antimicrobial Prescribing Group (SAPG) through benchmarking of performance across NHS Boards, shared learning and best practice, and aligning local activity with national priorities.

A review of the indicators is conducted on a 6-monthly basis by SAPG/ Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland through national governance structures. This enables ongoing tracking of progress and ensures maximum impact toward achieving the NAP targets.

Scotland’s coordinated approach demonstrates how nationally agreed indicators, combined with local delivery and data-driven improvement, can support optimisation of antimicrobial use and contribute to achieving AMR NAP targets.

Improving communication between healthcare professionals and the public

Barriers and strategies to improve communication

Literacy and understanding

Medical terminology and long explanations can be difficult to understand, particularly for people with lower health literacy. To address this, use plain, everyday language, avoid long sentences, and tailor terminology to the audience’s level of understanding. Simple charts, drawings, or visual aids can help explain more complex ideas.

For example, the CHESTSSS tool was developed to improve specific communication techniques with patients about antibiotics.

Language barriers and access to information

Limited access to suitable translated verbal and written information can reduce understanding of key AMR messages, including basic terms such as “antibiotic.” For people with limited English proficiency, reliance on unregulated translation tools or family members may result in inaccurate or unclear information.

Providing professionally translated materials and checking understanding can improve clarity and safety.

Ensuring materials are available in accessible formats such as spoken information, pictures, large print, easy read, and British Sign Language supports inclusive communication (see section ‘Factors associated with health inequalities for culturally sensitive tools/materials’).

Cultural beliefs and perceptions of illness

Cultural beliefs may influence how illness is understood, for example where symptoms are attributed to spiritual, environmental, or balance‑related causes rather than microbes. Respecting these beliefs, asking what matters most to the person, and explaining AMR in a culturally sensitive way helps build trust and shared understanding.

Emotional factors and health anxiety

Health anxiety can cause stress and fear, making it harder for people to listen, understand, and retain information. Using calm, reassuring language, repeating key messages, and focusing on positive, solution‑focused advice can support better engagement.

Time constraints in consultations

Short appointment times can limit explanations and checks for understanding. Prioritising key messages, repeating important points, and encouraging open questions such as ‘What worries you most?’ can improve the quality of communication within limited time.

Consistency, trust, and misinformation

Mixed or conflicting messages from different sources including social media can reduce trust and confidence in health professionals, as seen with vaccine mistrust and antibiotic myths. Keeping advice consistent across health campaigns, addressing misinformation directly, and sharing success stories can help build trust and confidence.

Promoting shared decision‑making, for example using resources such as the TARGET Antibiotics Toolkit, helps involve patients in choices and supports clearer, more meaningful conversations.

In some instances, prescribing information could also make a significant difference by helping patients understand why an antibiotic was or was not prescribed. This information could be provided as a printed takeaway leaflet or through a dedicated website, enabling patients to make more informed decisions and better understand their treatment.

Educational and Awareness Initiatives Infections and AMR

Inclusion of AMS and AMR into education curricula

In England, AMR and AMS has been incorporated into both the school science curriculum and the education and training of healthcare professionals. This helps raise awareness of AMR and AMS from an early age while also ensuring that healthcare workers understand the importance of responsible antimicrobial use.

However, there remain opportunities to strengthen this policy area, as variation exists across professions and institutions, and there is a need to consider broader inclusion within social care education programmes.

Examples of educational materials that can support teaching and engagement in this area:

Primary and secondary school

Undergraduate and higher education

Workforce education

Case study: Raising awareness of AMR in children and young people and those that care for them, a multi-method approach in Southend-on-Sea, England

This project was one of the winners of the Antibiotic Guardian Share Learning2024/25 Award.  Led by UKHSA, NHS East of England, and Southend Council the group developed and piloted a new “Tools for Schools” AMR communications toolkit to raise awareness of antimicrobial resistance among children, young people, and their caregivers. It collated high-quality resources from programmes such as e-Bug, Antibiotic Guardian, UKPAS, TARGET, and vaccination campaigns for use in schools, healthcare settings, and local authority services. The team used a multichannel approach, social media, blogs, school newsletters, letters to headteachers, and community webpages, and delivered interactive workshops and a schools’ poster challenge to engage families. The project reached over 30,000 children across 60 schools, improving their awareness of AMR significantly.

Case study: A knowledge and skills framework for health and social care in Scotland

NHS Education for Scotland, in collaboration with the SAPG and Glasgow Caledonian University, created a new framework to support the education of health and social care staff and students in Scotland. Containing and controlling antimicrobial resistance: a knowledge and skills framework for health and social care in Scotland provides a tool to assess AMR and AMS throughout the care pathway. It highlights where staff can contribute throughout the patient journey to ensure the safe and effective use of antimicrobials and the safety of those in their care. Through embedding AMS training for healthcare staff and students, the project is helping ensure current and future generations of health professionals are better equipped to appropriately prescribe to patients.

Case study: All-Wales AMR Educators (AWARE) project

The AWARE project is an interprofessional virtual community for healthcare professionals working in AMS in Wales, including antimicrobial pharmacists, pharmacy technicians, nursing staff and microbiologists.

The community creates and shares teaching and training resources on a dedicated, free-to-access AWARE project website.

Case study: Promoting the use of e-Bug in primary and post-primary schools in collaboration with NI STEM ambassadors.

Following the relaunch of e-Bug in Northern Ireland, the programme has been promoted to primary and post-primary schools through collaboration with the Northern Ireland STEM Ambassador programme.

The STEM Ambassador programme supports engagement with science, technology, engineering and mathematics (STEM) by connecting children and young people with volunteers from a range of STEM-related backgrounds.

Through this collaboration, antimicrobial resistance education has been delivered in schools across Northern Ireland. Participating STEM Ambassadors include life science professionals from local academic institutions, as well as students involved in STEM Ambassador groups within post-primary schools.

Post-primary school students have also supported the delivery of e-Bug activities in neighbouring primary schools. This peer-led approach provides opportunities for students to develop their understanding of AMR and public health topics, while gaining experience in communication and leadership. For primary school pupils, learning from older students may help increase engagement with the subject matter and support understanding of key concepts.

This collaborative approach has enabled the delivery of AMR education across different age groups and has provided opportunities for young people to participate in STEM and public health-related activities.

Public awareness campaigns

Public awareness campaigns are an important part of efforts to tackle AMR by improving knowledge and encouraging behaviour change. They help increase understanding of infection prevention and control, appropriate antibiotic use, and the actions individuals can take to reduce the spread of infections.

There follow some public awareness campaigns on infection and AMR:

Ready-to-use public facing resources

A range of ready-to-use resources for patient and public engagement is available through the Campaign Resource Centre on GOV.UK. These resources cover a variety of infection and AMR related topics, including vaccination programmes, Pharmacy First campaigns, and the Antibiotic Awareness campaign, and can be used to support education and engagement activities with patients and the wider public.

In addition, charities such as Asthma + Lung UK provide useful digital resources on topics such as chest infections, which can help raise awareness and support public understanding of respiratory health and appropriate antibiotic use.

The Antimicrobial resistance awareness: toolkit for healthcare providers also contains useful resources predominately aimed at healthcare providers, local authorities and others in planning activities for WAAW and EAAD as well as engagement with the Antibiotic Guardian campaign, to encourage responsible use of antimicrobials.

Case study: ‘Andi Biotic’ national public awareness campaign

UKHSA developed a low-cost, in-house campaign targeting adults aged 18 to 34, although resources can be used for all ages. The campaign supports the delivery of the UK’s 2024 to 2029 National Action Plan for AMR, which commits UKHSA to trial evidence-based approaches to public engagement.

The campaign used Andi Biotic, a character featured in a series of short videos highlighting common ways antibiotics are misused, such as taking them for colds and flu, keeping leftover antibiotics, or not following healthcare advice. The campaign was developed using insights from audience testing, which suggested that humour would help engage younger people. It was promoted through social media, media coverage, and partner organisations across a range of sectors. Delivered in two phases during 2025, the campaign achieved high levels of reach and engagement, with the second phase generating increased views, shares, comments and overall audience interaction.

Andi Biotic’ national public awareness campaign

Case study: Living Well programme – Northern Ireland

The Living Well programme delivers public health advice through community pharmacies in Northern Ireland, using structured campaigns aligned to public health priorities to address key risk factors for disease. The programme has an extensive reach across all sectors and demographics of the community as it delivers public health messaging via pharmacy teams who actively engage patients to provide information, advice and support when they drop into the pharmacy.

The ‘Stay Well This Winter’ campaign (October to November 2025) aimed to help the public prepare for winter and reduce pressure on health services by promoting preventative behaviours. It targeted the general population, particularly older adults, pregnant women, and those with long-term conditions. Key messages focused on seasonal vaccination uptake, self-care for minor illness, and appropriate antibiotic use among other topics. Pharmacies reinforced these messages through leaflets, displays, conversations, and signposting to services.

Evaluation findings show the campaign was widely delivered across 504 pharmacies, with strong engagement particularly among older age groups and vulnerable populations. Pharmacy teams frequently supported patients with queries about vaccines, symptoms, illness duration, self-care and antibiotic use, and reached groups such as older people, those with long-term conditions, and socially isolated individuals.

The campaign had a positive impact, including increased awareness and uptake of vaccinations, improved patient confidence in self-care, and better understanding of when antibiotics are appropriate. Pharmacy interventions also helped address vaccine hesitancy, counter misinformation, and signpost patients to appropriate care. Additionally, antimicrobial stewardship was strengthened through widespread use of the TARGET Antibiotic Checklist, supporting safe and informed antibiotic use.

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