The UK AMR Strategy recognises the importance of changing the behaviours of healthcare workers and the public as a means of improving the stewardship of antimicrobials. However, the effectiveness of antimicrobial stewardship programmes, infection prevention and other interventions are in some cases hindered by failure to consider the adopting context (structural, economic and cultural dimensions) and the multi-professional nature of healthcare and how that impacts on cultures and decision making.

A better understanding of the cultural determinants of antibiotic decision-making, through the application of social science research methods, rather than traditional qualitative methodologies, will lead to the development of contextually fit interventions that are sustainable and locally owned. Our researchers have led much of the work in this field and are building capacity in LMICS by taking the learning from the NHS to India and South Africa as well as providing teaching, training, and mentoring to healthcare professionals in Norway, France, the Netherlands and Portugal.


Charani E, Smith I, Skodvin B, et al, Investigating the cultural and contextual determinants of antimicrobial stewardship programmes across low-, middle- and high-income countries - a qualitative study, PLoS One. 2019;14(1):e0209847.

Charani E, Ahmad R, Rawson T, et al, The differences in antibiotic decision-making between acute surgical and acute medical teams – an ethnographic study of culture and team dynamics. Clinical Infectious Diseases 2018.

Lorencatto F, Charani E, Sevdalis N, et al, Driving sustainable change in antimicrobial practice: how can social and behavioural sciences help? Journal Antimicrobial Chemotherapy 2018; 73(10):2613-2624.

Pulcini C, Binda F, Lamkang AS, et al, Developing core elements and checklist items for global hospital antimicrobial stewardship programmes: a consensus approach. Clinical Microbiology and Infection. 2018 Apr 2. pii: S1198-743X(18)30295-7.

Rzewuska M, Charani E, Clarkson JE, et al, Joint Programming Initiative on Antimicrobial Resistance (JPIAMR) Working Group on Behavioural Approaches to Antibiotic Stewardship Programs. Prioritizing research areas for antibiotic stewardship programmes in hospitals: a behavioural perspective consensus paper. Clinical Microbiology and Infection, 2018 Sep 7, pii: S1198-743X(18)30598-6.