Graells Tiscar, Lambraki Irene A, Cousins Melanie, Léger Anaïs, Lillepold Kate, Henriksson Patrik J G, Troell Max, Carson Carolee A, Parmley Elizabeth Jane, Majowicz Shannon E, Wernli Didier, Jørgensen Peter Søgaard
Global Economic Dynamics and the Biosphere, Royal Swedish Academy of Sciences, 114 18 Stockholm, Sweden.
Stockholm Resilience Centre, Stockholm University, 106 91 Stockholm, Sweden.
Antibiotics (Basel). 2022 May 10;11(5):639. doi: 10.3390/antibiotics11050639.
Antimicrobial resistance (AMR) affects the environment, and animal and human health. Institutions worldwide have applied various measures, some of which have reduced antimicrobial use and AMR. However, little is known about factors influencing the success of AMR interventions. To address this gap, we engaged health professionals, designers, and implementers of AMR interventions in an exploratory study to learn about their experience and factors that challenged or facilitated interventions and the context in which interventions were implemented. Based on participant input, our thematic analysis identified behaviour; institutional governance and management; and sharing and enhancing information as key factors influencing success. Important sub-themes included: correct behaviour reinforcement, financial resources, training, assessment, and awareness of AMR. Overall, interventions were located in high-income countries, the human sector, and were publicly funded and implemented. In these contexts, behaviour patterns strongly influenced success, yet are often underrated or overlooked when designing AMR interventions. Improving our understanding of what contributes to successful interventions would allow for better designs of policies that are tailored to specific contexts. Exploratory approaches can provide encouraging results in complex challenges, as made evident in our study. Remaining challenges include more engagement in this type of study by professionals and characterisation of themes that influence intervention outcomes by context.
抗菌药物耐药性（AMR）影响环境、动物健康和人类健康。世界各地的机构已采取各种措施，其中一些措施减少了抗菌药物的使用和AMR。然而，对于影响AMR干预措施成功的因素知之甚少。为了填补这一空白，我们让AMR干预措施的卫生专业人员、设计师和实施者参与了一项探索性研究，以了解他们的经验以及对干预措施构成挑战或促进干预措施的因素，以及实施干预措施的背景。根据参与者的意见，我们的主题分析确定了行为、机构治理与管理以及信息共享与强化是影响成功的关键因素。重要的子主题包括：正确行为强化、财政资源、培训、评估以及AMR意识。总体而言，干预措施位于高收入国家、人类部门，由公共资金资助和实施。在这些背景下，行为模式对成功有很大影响，但在设计AMR干预措施时往往被低估或忽视。加强我们对促成成功干预措施因素的理解，将有助于更好地设计针对特定背景的政策。探索性方法在复杂挑战中可以产生令人鼓舞的结果，正如我们的研究所表明的那样。剩下的挑战包括专业人员更多地参与这类研究，以及按背景对影响干预结果的主题进行特征描述。
