Shaping the future: Current landscape and potential impact of educating children and adolescents on antimicrobial resistance – a systematic review and narrative synthesis

This systematic review synthesised 119 antimicrobial resistance (AMR) educational initiatives for school-aged children and adolescents across 44 countries, spanning both high- and lower middle-income settings. Most initiatives used lesson plans (40%) or games (43%) and primarily aimed to improve AMR knowledge, typically applying learner-centred (constructivist) pedagogical approaches. While 44 initiatives formally evaluated knowledge gains—consistently showing improvement—only three reported intended or self-reported behaviour change, and none measured objective AMR-related outcomes. Thirty initiatives were aligned with regional curricula. Overall, current AMR education efforts focus largely on awareness and knowledge rather than developing practical skills for behaviour change. The review, strengthened by an open global call for submissions, highlights the need for more innovative, participatory pedagogies and stronger evaluation of behavioural impact, in line with UN recommendations on global collaboration and resource sharing in AMR education.