TY - JOUR T1 - Research forum: imaging a post-antimicrobial future JF - Medical Humanities JO - J Med Humanit SP - 357 LP - 358 DO - 10.1136/medhum-2022-012485 VL - 48 IS - 3 AU - Rachel Irwin AU - Kristofer Hansson Y1 - 2022/09/01 UR - http://mh.bmj.com/content/48/3/357.abstract N2 - Antimicrobial resistance, or AMR,1 is a global challenge, with the WHO declaring it one of the ‘top 10 global public health threats facing humanity’. Specifically, the WHO, governments and researchers have highlighted the ‘misuse and overuse of antimicrobials’, and the lack of clean water, sanitation and preventative measures, specifically noting concern over resistant strains of gonorrhoea, methicillin-resistant Staphylococcus aureus influenza, HIV, malaria and tuberculosis (WHO 2021). AMR leads to increased morbidity, mortality and costs from infections, not least as a patient may cycle through several antimicrobials before an effective one is prescribed. Additionally, many second-line and third-line (and beyond) antimicrobials are not readily available in low-resource settings. Moreover, antimicrobials are regularly prescribed as a prophylaxis, for instance, to prevent infection in routine surgeries (WHO 2021).There have long been concerns over AMR within the medical community, going back at least to 1907 (Hutchison, page 359). Sir Alexander Fleming, who discovered penicillin, used his Nobel prize acceptance speech in 1945 to warn of the risk of resistance, and to blame a hypothetical patient who ‘misuses’ medicine:The time may come when penicillin can be bought by anyone in the shops. Then there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant. Here is a hypothetical illustration. Mr. X. has a sore throat. He buys some penicillin and gives himself, not enough to kill the streptococci but enough to educate them to resist penicillin. He then infects his … ER -