Fighting Superbugs: Can Social Science Win the Battle Against Antibiotic Resistance?

Nico Varela in Health & Wellness December 2025 • 4 min read.

"Discover how behavioral insights are key to changing prescribing habits and slowing the rise of antimicrobial resistance."

The rise of antibiotic-resistant bacteria poses a significant threat to global health. While new drugs are part of the solution, changing human behavior—specifically how antibiotics are prescribed and used—is crucial. This means reducing unnecessary antibiotic use and preventing infections in the first place.

Current strategies to improve antibiotic prescribing, known as antimicrobial stewardship programs (ASPs), often fall short. While there's plenty of evidence that ASPs can be effective, many don't adequately consider the social and behavioral factors that influence prescribing decisions. This is where the social and behavioral sciences can make a real difference.

By understanding the 'why' behind prescribing behaviors, we can design more effective and sustainable interventions. This article explores how insights from these fields can be applied to improve ASPs, focusing on defining the problem, using theory-driven design, ensuring practical implementation, and maximizing learning from past efforts.

Why 'What' and 'Whose' Matter: Getting Specific About the Problem

Stylized image of a brain intertwined with pills and bacteria, symbolizing the balance needed in antimicrobial stewardship.

Many interventions aimed at changing healthcare professionals' behavior are designed without a clear understanding of what drives those behaviors in the first place. Instead of relying on assumptions or 'best guesses,' the social and behavioral sciences emphasize the importance of a thorough 'behavioral diagnosis.'

Think of it like this: you wouldn't prescribe medication without assessing a patient's symptoms. Similarly, you shouldn't implement an ASP without understanding why antibiotics are being prescribed in the first place. This involves clearly defining the target behavior: who needs to do what differently, for whom, where, and when?

Who: Is it surgeons, general practitioners, or nurses whose behavior needs to change?
What: Are you targeting the decision to prescribe, the choice of antibiotic, the duration of treatment, or something else?
Where: Is the focus the hospital, primary care clinic, or long-term care facility?
When: Does the issue arise during initial assessment, during treatment, or at discharge?
Whom: Which type of patients does this behavior affect?

For example, instead of a vague goal like 'improve infection control,' a specific behavioral target would be 'surgeons working on the cardiac surgery ward stopping antibiotics 24 hours after surgery for coronary artery bypass graft patients.' This level of specificity is crucial for effective intervention design and measurement.

Key Takeaways for Effective Antimicrobial Stewardship

The social and behavioral sciences offer valuable tools and frameworks for designing and implementing effective ASPs. By understanding the factors that influence prescribing behaviors, we can move beyond simple education and create interventions that address the complex realities of healthcare settings.

Here are some key recommendations:

<ul><li>Clearly define the problem in behavioral terms.</li><li>Conduct a 'behavioral diagnosis' to understand the factors influencing prescribing.</li><li>Match intervention strategies to the specific behavioral diagnosis.</li><li>Consider the broader social and environmental context.</li><li>Draw on evidence from the broader behavior change literature.</li><li>Assess implementation and sustainability.</li><li>Describe and report interventions comprehensively.</li></ul>

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1093/jac/dky222, Alternate LINK

Title: Driving Sustainable Change In Antimicrobial Prescribing Practice: How Can Social And Behavioural Sciences Help?

Subject: Infectious Diseases

Journal: Journal of Antimicrobial Chemotherapy

Publisher: Oxford University Press (OUP)

Authors: Fabiana Lorencatto, Esmita Charani, Nick Sevdalis, Carolyn Tarrant, Peter Davey

Published: 2018-07-17

Everything You Need To Know

Why do antimicrobial stewardship programs sometimes fail to effectively change antibiotic prescribing habits?

Antimicrobial stewardship programs frequently miss the mark because they don't adequately consider the social and behavioral factors influencing prescribing decisions. The social and behavioral sciences can provide insights into the 'why' behind these behaviors. By defining the problem, using theory-driven design, ensuring practical implementation, and maximizing learning from past efforts, the programs can become more effective and sustainable. A 'behavioral diagnosis,' is crucial, similar to assessing a patient's symptoms before prescribing medication.

What specific factors should be considered when defining a behavioral target within an antimicrobial stewardship program?

A specific behavioral target should be identified by considering 'Who,' 'What,' 'Where,' 'When,' and 'Whom.' For example, instead of a vague goal like 'improve infection control,' a specific behavioral target would be 'surgeons working on the cardiac surgery ward stopping antibiotics 24 hours after surgery for coronary artery bypass graft patients.' This level of specificity is crucial for effective intervention design and measurement.

How can the social and behavioral sciences improve the design and implementation of antimicrobial stewardship programs?

The social and behavioral sciences offer frameworks for designing and implementing effective antimicrobial stewardship programs. By understanding the factors that influence prescribing behaviors, we can move beyond simple education and create interventions that address the complex realities of healthcare settings. By understanding the 'why' behind prescribing behaviors, interventions can be designed that are more effective and sustainable.

Besides developing new drugs, what other approaches are essential in combating antibiotic resistance, and why are they important?

Addressing unnecessary antibiotic use and preventing infections are crucial steps. This can be achieved by changing human behavior related to how antibiotics are prescribed and used. Current antimicrobial stewardship programs often fall short because they don't adequately consider the social and behavioral factors that influence prescribing decisions. The social and behavioral sciences offer valuable tools for designing and implementing effective programs.

How can social and behavioral sciences help in understanding and modifying the prescribing behaviors of healthcare professionals to combat antimicrobial resistance?

Social and behavioral sciences are crucial to changing the behavior of healthcare professionals by understanding what drives their actions. This involves a thorough 'behavioral diagnosis' to identify the target behavior by specifying who needs to do what differently, for whom, where, and when. This approach helps to design more effective and sustainable interventions that address the complex realities of healthcare settings, going beyond simple education.