Developing public health risk messages about antibiotic resistance using metaphors: an international co-design and e-Delphi consensus study

This study presents an international co-design and e-Delphi consensus process to develop more effective public health messages about antimicrobial resistance (AMR), focusing specifically on the use of metaphors. The researchers engaged experts and stakeholders to identify which types of metaphors best communicate AMR risks and motivate behavioural change. They found that commonly used “war” or “apocalyptic” metaphors can be misleading or counterproductive, while more constructive, relatable metaphors (e.g., framing antibiotics as a shared resource that can be “depleted”) are more effective in improving understanding and encouraging responsible antibiotic use. The study concludes that carefully designed, evidence-based communication strategies are essential to influence public behaviour and support antimicrobial stewardship efforts.