Guidance

World Antimicrobial Resistance Awareness Week (WAAW) and European Antibiotic Awareness Day (EAAD)

Updated 18 September 2025

Applies to England

´ǰAMRAwareness Week 2025

Introduction

This toolkit aims to provide quick and ready-to-use resources to support local´ǰAMRAwareness Week (WAAW)campaigns. The toolkit is focused on digital messaging to support speed and ease of communication, while including a wide variety of suggestions for engagement with healthcare professionals, patients and members of the public.

WAAW takes place from 18 to 24 November each year andis led globally bythe World Health Organization (WHO). It aims to increase awareness of globalantimicrobial resistance (AMR)and to encourage best practices among the public, health workers and policy makers to avoid the further emergence and spread of drug-resistant infections.

The WHO renamed World Antimicrobial Awareness Week to World Antimicrobial Resistance Awareness Week, or ´ǰAMRAwareness Week, after global consultations in 2023.

European Antibiotic Awareness Day (EAAD), led by the European Centre for Disease Control (ECDC) is a public health initiative aimed at encouraging responsible use of antibiotics. It is held on 18 November every year.

In 2014,Public Health England(PHE) (nowUKHSA) developed the Antibiotic Guardian campaign. The pledge-based campaign website and associated resources aim to provide educational resources and increase commitment from healthcare workers and members of the public, to help tackleAMRin the UK. The campaign is a collaboration with the Department of Health and Social Care, Veterinary Medicines Directorate (VMD), the 4 UK nations, local government, and professional organisations.

In the UK, national WAAW activities and resources are led by UKHSA, NHS England, Scottish Government, Public Health Wales and Public Health Agency Northern Ireland.

In England, UKHSA and VMD lead national planning WAAW groups for human and animal health respectively. These groups agree a national focus, develop or recommend key resources for local activities, facilitate shared learning across the 4 UK nations, as well as seek input from those leading activities across a variety of organisations.

Raising awareness ofAMRis important to encourage collective action to help us reduce the risks of this crisis.

Whether you intend on supporting a small or big campaign within your organisation, all antimicrobial stewardship (AMS) helps to keep antibiotics working. Please do what you can to get involved during and beyondWAAW.

In addition to the toolkit, each year in November to coincide with WAAW, NHS England issues a letter to chief executive officers, chiefs and directors of trusts, Integrated Care Boards and Primary Care Networks, co-signed by senior leaders from NHS England and UKHSA, including NHS England chief professional officers as well asUKHSAChief Medical Advisor. The letter is an opportunity to draw the attention of NHS senior leadership teams to the threat of AMR, to stimulate further engagement with this issue and to promote shared ideas for improvement and implementation Information on AMR and WAAW is also sent to local authorities, care providers and professional organisations via relevant bulletins, such as the UKHSA weekly bulletin and NHS England Primary Care Bulletin.

NHS England also coordinates a series of webinars during WAAW, aimed at healthcare professionals from across all sectors, on key AMS initiatives with insights from local AMS leaders. More information on the 2024 NHS England WAAW webinar series and registration is available via the .

For other relevant antibiotic resources, see.

Access all the.For more information on each of the resources, see the relevant section of this toolkit.

WAAWresources specific for:

WAAW activities for animal health is coordinated by .

For queries about the campaign, contact theWAAW,EAADand Antibiotic Guardian National Lead, Dr Diane Ashiru-Oredope, atESPAUR@ukhsa.gov.uk

Aim and focus

WAAWaims to increase awareness of global AMR and to encourage best practices for using antimicrobials responsibly among the public, health workers and policy makers, to avoid the further emergence and spread of drug-resistant infections.

Antibiotic Guardian,EAADԻWAAWsupport the aims of theUK 20-year vision forAMR and 5-year national action plans which set out actions to slow the development and spread ofAMR.

The UK’s current 5-year national action plan (NAP) ‘Confronting antimicrobial resistance 2024 to 2029’, published in May 2024, focuses on further developing many of the main areas outlined in the 2024 to 2029 NAP, with activity divided into 4 themes:

  • reducing the need for, and unintentional exposure to, antimicrobials
  • optimising the use of antimicrobials
  • investing in innovation, supply and access
  • being a good global partner

The NAP also includes 5 human health targets. These are that by 2029, we aim to:

  • prevent any increase in a specified set of drug-resistant infections in humans from the 2019 to 2020 financial year (FY) baseline
  • prevent any increase in Gram-negative bloodstream infections in humans from the 2019 to 2020 financial year baseline
  • increase UK public and healthcare professionals’ knowledge on AMR by 10%, using 2018 and 2019 baselines, respectively
  • reduce total antibiotic use in human populations by 5% from the 2019 baseline
  • achieve 70% of total use of antibiotics from the Access category (new UK category) across the human healthcare system

The questions used to assess the health target on the public and healthcare professionals knowledge on AMR are:

  1. “Antibiotic are effective against viruses”
  2. “Antibiotics are effectives against cold and flu”
  3. “Unnecessary use of antibiotics makes them become ineffective”
  4. “Taking antibiotics has associated side effects or risks such as diarrhoea, colitis, allergies”
  5. “Every person treated with antibiotics is at an increased risk of antibiotic resistant infection”
  6. “Antibiotic resistant bacteria can spread from person to person”
  7. “Healthy people can carry antibiotic resistant bacteria”

We encourage that education on these questions is embedded into any education and training on infection prevention and control, AMR and AMS. The narrative for the correct answers is available . In addition, when delivering education and training to health students and healthcare professionals on AMS, consider using the national antimicrobial prescribing and stewardship competency framework in identifying learning outcomes and areas of focus.

Find that can be used to support training activities for future and current healthcare professionals as well as map and benchmark courses.

Figure 1. Key priorities of the 2024 to 2029 NAP across the 4 themes

Figure 1 shows 4 themes side by side. The box on the far left contains the text: Reducing the need for, and unintentional exposure to, antimicrobials: infection prevention and management, public engagement and education, strengthened surveillance. The middle-left box contains the text: Optimising the use of antimicrobials: antimicrobial stewardship and disposal, AMR workforce. The middle right box contains the text: Investing in innovation, supply and access: innovation and influence, using information for action, health inequalities. The far-right box contains the text: Being a good global partner: AMR diplomacy.

ճNAPincludes communication materials that can be shared on social media, email campaigns and other presentations.

Main messages around AMR to consider for WAAW 2025

Messages for healthcare professionals onAMS

As the COVID-19 pandemic and recent outbreaks have highlighted, management of viral infection remains an important challenge for healthcare professionals and can have an adverse impact on the use of antibiotics.

Now more than ever, we need to continue to work together to prevent serious infections through infection prevention and control measures and encouraging the uptake of vaccinations when recommended, while reducing inappropriate antibiotic use.

To avoid inappropriate antibiotic prescribing in the context of COVID-19 and other viral infections, we recommend that healthcare professionals:

  • followto infer if pneumonia has a COVID-19, viral or bacterial cause
  • treat coughs, fever and breathlessness related to COVID-19 in line with, not with antibiotics – please consider appropriate pathways for diagnosis, testing and clinical management
  • explain to patients that antibiotics do not prevent or treat viral infections including COVID-19 and that antibiotics can cause side-effects, including nausea and diarrhoea – their use can also increase the risk of spreading infections that are caused by bacteria resistant to antibiotics

Tackling AMR through a One Health approach

Antimicrobial resistant microbes can spread between and within human, animal, and plant populations as well as throughout the environment. This means a One Health approach, where people across these sectors work together to combat a problem, is needed to tackleAMR.

The One Health Antibiotic Guardian campaign, led byUKHSA, aims to stimulate behaviour change and increase engagement across all sectors, to tackleAMR, through an online, action-based pledge system. There have been pledges from over 129 countries and the pledges are available in 5 languages.

UKHSAwork closely with partner organisations, such as VMD, to ensure initiatives such as the Antibiotic Guardian School Ambassadors scheme includethat can be utilised across all sectors.

A joint report on antibiotic use in animals and humans and antibiotic resistance in the UK between 2014 and 2019 was published in 2023, called UK One Health Report: Joint report on antibiotic use, antibiotic sales and antibiotic resistance.

See resources on the from the British Veterinary Profession.

UKHSA’s national campaign for the public: Keep Antibiotics Working (Andi Biotic)

UKHSA has created a new campaign to help keep antibiotics working, fronted by our mascot Andi Biotic. Andi Biotic is on a mission to make people aware of the correct ways to use antibiotics so we can all help to tackle the threat of AMR.

Our research tells us that there is a high level of public awareness about the risks of AMR to the nation’s health, yet most people do not know what they can personally do to combat it. Misconceptions about antibiotics and incorrect behaviours remain prevalent among the groups that use antibiotics the most – younger people and ethnic minority groups.

As a result, we have created a campaign that aims to increase public awareness and understanding of the correct and incorrect antibiotic behaviours, using the below 3 messages:

  1. Don’t take antibiotics for colds and flu
  2. Don’t save antibiotics for later
  3. Take antibiotics as directed by your healthcare professional.

The primary target audiences of our campaign are adults aged 18 to 34 with a focus on:

  • males
  • Black/Black British and Asian/Asian British communities
  • people from lower-income and working-class communities, including those in manual jobs or currently out of work, in the C2DE social grade (encompasses individuals in semi-skilled and unskilled manual occupations, as well as those who are unemployed or in the lowest grade of occupations)

Further information on the campaign can be found .

The next phase of the UKHSA Keep Antibiotics Working campaign will start alongside WAAW, seeing the return of Andi Biotic who is on a mission to help the public understand the responsible ways to use antibiotics. The previous phase ran in April and May which saw Andi Biotic introduced along with the missions.

Our campaign is particularly focussed on young adults aged 18 to 34, but its messages are universal.

As our priority audience is a younger one, the majority of campaign activity will be on social media channels, but we have also created a range of other print ready and digital assets for community and communal places. Andi can be found across all campaign materials, in videos showing him addressing the most common misconceptions about antibiotics, and on digital and print assets which provide key information to the public.

Campaign materials will be running on our social media channels for three weeks starting on Monday November 17.

We are asking others who have an audience to help get involved by sharing the assets and the messages with their stakeholders and key audiences to help spread the mission of Andi Biotic and to keep antibiotics working.

All assets can be found on the .

Figure 2. Keep Antibiotics Working Campaign

Helpful resource: antimicrobial resistance systems map

AnAMRsystems mapwas developed by Department of Health and Social Care,VMD, Public Health England (nowUKHSA), and the Department for Environment Food and Rural Affairs. It influences the development ofAMRat top level. It shows how humans and their food, the environment (including water, crops and land), and animals (including food animals, companion animals and wildlife) are all interconnected through various means such as pathway for microbes, and high-level influences and interventions.

SuggestedWAAWdaily themes for activities

WAAWruns from 18 to 24 November each year, irrespective of which weekdays these fall on. Below are suggestions of themes for each of the 5 weekdays inWAAWthat colleagues can use or adapt to base their own localWAAWactivities and communications on. The themes have also been mapped to highlight which of the 2024 to 2029 national action plan on AMR they align to.

Find .

Day 1: ‘Prevention’ theme (including infection prevention and control measures and vaccination). This themes links to outcome 1 (infection prevention and control and infection management) of the NAP.

Day 2: ‘Antimicrobials in clinical practice’ theme (for example, consider audits on or promoting good practice for antibiotic course length, promoting shorter course length, empiric prescribing, intravenous-oral switch, promotion of current clinical guidelines, antimicrobials and untrue or spurious allergy - including issues such as untrue penicillin allergy labels and de-labelling spurious antibiotic allergy labels). This theme links to outcome 4 (antimicrobial stewardship and disposal) of the NAP.

Engagement with patients and the public – see toolkit section on
public awareness. This links to outcome 2 (public engagement) of the NAP.

Day 3: ‘Optimising diagnostics’ theme (increasing understanding of established and innovative methods of detection of infection, antibiotic-resistant or otherwise). This theme links to outcome 6 (innovation and influence) of the NAP.

Day 4: ‘Tackling health inequalities’ theme (exploring how factors such as age, deprivation, ethnicity, and learning disability influence antibiotic use, infection risk, and resistance. Emphasis on equity in access and care, particularly for populations). This theme links to outcome 8 (Health disparities and health inequalities) of theNAP.

Day 5: ‘One Health and research’ theme (One Health approaches to tacklingAMR across human health, animal health and the environment, such as disposal of antibiotics and environmental contamination. Research activities focused on tackling AMR may also be highlighted on this day). This theme links to the One Health approach of the UK AMR NAP and outcome 7 (using information for action) of theNAP, which includes the top 10 research priorities.

, aligned with each daily theme, can be downloaded to use for communications.

Cross-cutting themes underpinning all 5 days

There are 3 cross-cutting themes underpinning all 5 days:

  • children and young people
  • sustainability
  • research

Children and young people

Antibiotic use in children is high, especially in the zero-to-4-years category, is often inappropriate and is associated with harmful long-term effects linked to disruption of the gut microbiome.

Upper respiratory tract infections are prevalent in children, often leading to healthcare consultations and antibiotic prescribing – at least 40% of children are prescribed antibiotics for chest infections (). Antibiotics are prescribed for a range of medical and non-medical reasons including perceived vulnerability of children (), concern about a rapid change in clinical state (), and to mitigate a perceived risk of future hospital admissions and complications (), yet the evidence shows that for respiratory tract infections, the risk of complications is low and not prevented by prescribing antibiotics ().

There are a range of resources available below to support managing infection in children and young people.

Sustainability

As part ofWAAW, consider how you can play a role in reducing the impact of antimicrobial use on the environment and ensuring sustainable use.can be accessed online and used to support your activity.

Please consider the following suggested actions for how healthcare practitioners and the public can help to reduce adverse environmental impacts of antimicrobial use.

Suggested actions for healthcare practitioners to reduce the impact of antibiotics on the environment:

  • raise awareness with colleagues about the environmental effects of not disposing of antimicrobials in the correct way
  • teach students and junior staff the correct procedures for disposal of antimicrobials
  • encourage patients to return unused antimicrobials to their nearest pharmacy for safe disposal and not to flush antimicrobials down the toilet

Suggested actions for patients and carers to reduce the impact of antibiotics on the environment:

  • take unused or expired antibiotics to the local pharmacy for safe destruction
  • do not throw antibiotics down the drain or toilet
  • talk to friends and family about the safe disposal of antibiotics

Research

Research underpins all WAAW daily themes and aligns with outcome 6 (Innovation and Influence) and outcome 7 of the NAP (using information for action). It is an essential component in the fight against AMR, providing the information needed to develop evidence-based interventions and inform effective policy and practice.

As part of WAAW, consider using the following insights and questions to help shape impactful and evidence-based AMR research:

  • consider how you might align your research and evaluation work to the 10 research questions in the AMR National Action Plan. The following are some of the example questions:
    • which socioeconomic factors increase risk of infections, AMR, and inappropriate antimicrobial use?
    • what is the economic cost of leaving AMR unchecked?
    • what are the most effective interventions to build public trust, reduce misinformation, and communicate risks related to antibiotics?
    • what are the optimal interventions for infection outbreak management across healthcare settings?
    • when is it safe and effective to not use antimicrobials for the prevention and treatment of infections?
  • optimise management of infections by staying up to date with the latest research and evidence through the Antimicrobial Stewardship Observatory of Evidence on
  • the is capturing real world data on the treatment of resistant infections
  • for information on infection-related clinical trials see

Suggested actions for colleagues leading WAAW and EAAD activities within their organisations to consider

Please consider the following list of suggested activities to engage with ahead of, duringand after WAAW. For those with limited time, it is recommended that the first 5 actions are focused on.

1. Choose yourand encourage colleagues, family members and friends to do the same. You may wish to share your pledge on social media platforms to encourage others to join you also. Consider including the following hashtags in your social media posts:

  • AntibioticGuardian

  • KeepAntibioticsWorking

  • WAAW

  • ConfrontingAMR

2. Register your organisation’sAMRawareness activities by using the(this will take less than 5 minutes). Following registration, you will receive an email with your certificate for your organisation which can be displayed.

3. that can be used and shared duringWAAW. These resources build on those produced in 2020 and 2021, including digital notes, images and social media polls. They are discussed further below, along with the.

4. Visit thefor access to key national guidance, updates, and content available relating to infection management andAMR, and as a mechanism to share knowledge and to network with other colleagues across the country.

5. As part of your localWAAWplanning, view the recorded, which was held by the UK Health Security Agency (UKHSA). This includes discussions from a range of colleagues, while employing knowledge mobilisation principles to help colleagues plan their localWAAWand signpost to resources.

6. Participate in the Global X (formerly Twitter) relay which will run duringWAAW;are available online and will be updated as required. For further information, see the section on the Global X relay below.

7. Record and share a short pledge video to affirm your organisation’s (or your individual) commitment to tacklingAMR. There is guidance on recording a video and promoting duringWAAW below.

8. Visit theto engage with a range of resources designed to help all healthcare professionals to reduce antibiotic overuse in hospitals. We encourageARKsites to re-engage and all to learn from and use these resources.

9. Use the Keep Antibiotics Working resources that are still available online and free for healthcare professionals to download and use in local awareness campaigns, including during WAAW. The are in 12 languages. See Figure 10 for examples.

10. Explore the which is designed for healthcare professionals in all primary care or community settings. The toolkit includes the, which has been designed to follow the antibiotic prescription journey, to be completed by patients and pharmacy teams to facilitate individualised advice to the patient.

11. Use thesuite of educational resources to run engaging activities and sessions on microbes, infection and antibiotics for children aged 3 to 16. All activities and lesson plans are designed to complement the National Curriculum and can be adapted to meet the needs of your group.

12. Take the free e-Bug, which aims to improve your ability to teach children and young people how to prevent the spread of infection and to use antibiotics responsibly.

13. Encourage colleagues to become Antibiotic Guardian Schools Ambassadors. Further details including registration and access to the toolkit are available via .

14. Explore the Health Education England (HEE), which contains a range of educational resources related toAMRand infections. This is available for use by primary and secondary care.

15. Lead a local antibiotic amnesty campaign to encourage individuals to safely dispose of unused or leftover antibiotics in collaboration with community pharmacies and veterinary practices. Advice on running a campaign, as well as free and ready to use resources, are available via the . You can also find out about the .

16. Access the local, regional and national surveillance data on antimicrobial use and resistance.

The national English Surveillance Programme for Antimicrobial Use and Resistance (ESPAUR) report includes national data on antimicrobial prescribing and resistance, antimicrobial stewardship implementation, and awareness activities. ESPAUR continues to measure the impact of policy and guidance interventions. It does this through surveillance, via external stakeholders, of antimicrobial consumption, resistance and stewardship at local, regional and national levels. Data can also be submitted to international collections such as the .

The are produced by the UKHSA and include local and regional data across 6 domains including:

  • supporting NHS England initiatives
  • antimicrobial resistance
  • antibiotic prescribing
  • healthcare-associated infections
  • infection prevention and control
  • antimicrobial stewardship

17. Familiarise yourself with the 2024 to 2029 NAP, how it impacts your area of work and how you can contribute to meeting the proposed outcomes.

18. Consider leading or encouraging colleagues to complete the following stewardship actions:

  • undertake AMS audit and QI project
  • undertake training and education in AMS (BSAC, CPPE)
  • provide a training and education session to other HCPs or to patient participation groups
  • join a local AMS or AMR network
  • review local guidelines taking into consideration the UK-adapted AWaRE (Access, Watch, Reserve) categories available via FuturesNHS AMR platform

Figure 3. Being AWaRe categories

Figure 3 highlights the World Health Organization classification of key antibiotics into 3 categories (AWaRe) which are:

  • Access (improve access) – first and second choice antibiotics for treating the most common infections, includes amoxicillin for pneumonia and penicillin for Streptococcal sore throat
  • Watch (monitor important antibiotics) – antibiotics with increased toxicity concerns and higher resistance potential that should only be prescribed for specific indications to minimise unnecessary harm to patients and costs to health care systems, includes ciprofloxacin in the treatment of complicated urinary tract infection (UTI)
  • Reserve (preserve ‘last resort’ antibiotics) – antibiotics that are last-resort options that only should be used in severe circumstances, when other options have failed, includes colistin and IV parenteral fosfomycin

Adapted by the UK for the National Action Plan.

Suggested actions all individuals can consider

As an individual, for sharing learning and resources ahead of or duringWAAW, you may wish to consider:

  • forwarding this toolkit to colleagues
  • continuing to encourage colleagues or members, family, friends and patients to join over 200,000 individuals who have personally pledged an action to help to tackleAMRby choosing a pledge at the
  • using social media and community networks to engage with diverse population groups to promote key messages onAMRthroughout the winter season using #AntibioticGuardian and #KeepAntibioticsWorking –are available online
  • professional and personal networks that you can share information on (organisational intranet, community groups, local message boards)
  • if you are a parent, utilising your school newsletter or parent networks
  • finding your local counciland contacting them about sharing resources with schools and healthcare providers (including care homes)
  • contacting your dentist to ask if they will accessa to display in their waiting room
  • if you are a pet owner, contacting your veterinary practice about sharing resources in the surgery and with other pet owners – you can also return unused or unwanted antibiotics for pets to your vet practice as most will be participating in a veterinary amnesty this year
  • using social media to share some of thedetailed in this toolkit with family, friends, and colleagues
  • having a conversation with a colleague, family member or friend over coffee around antibiotics duringWAAW– chats could include discussions around
    • what you think your personal responsibility to keep antibiotics working is
    • why you might be thankful for antibiotics
    • the role of the health provider and patient in shared decision-making involving antibiotic prescribing
    • the role of preventing infections
    • self-care for self-limiting infections

Digital resources to share duringWAAW

A range of digital resources were initially created forWAAW2020 due to the COVID-19 pandemic. These digital resources are regularly reviewed by a sub-group of the UKHSA nationalWAAWԻEAADplanning group and are available for use in localawareness raisingcampaigns.

The resources include short messages, images and X (formerly Twitter) polls that can be quickly and easily shared duringWAAW, which are aligned with the suggested themes in the previous section. The use of digital resources also considers the priority to develop a greener NHS and reduce the use of paper resources. Many can also beand are available online.

They are designed to be suitable for primary and secondary care and for use by healthcare workers. We also encourage local teams to develop and share their own local messages. They can be shared via WhatsApp, used as screen savers, email signature or social media.

ճare available in blue and yellow designs and use different writing styles. A is also available. Two examples of the digital notes are shown in Figure 4. They are examples of both the yellow and blue backgrounds with 2 of the writing styles.

Figure 4. Examples of the digital sticky notes available for use duringWAAW

Figure 4 shows 2 digital ‘sticky note’ style images – one yellow on the left, and one blue on the right. The yellow digital note contains the text ‘Vaccination prevents infection’ while the blue note contains the text ‘STOP antibiotics if no evidence of bacterial infection’. These messages are both followed by the hashtags #AntibioticGuardian and #KeepAntibioticsWorking.

A range ofhave also been designed, based on 5 core themes (Start smart then focus, Empiric prescribing, Course length, Patient safety and Resistance). Figure 5 shows examples of local messaging using ‘digital thank you notes’. These can be adapted for local messaging and include your organisations logo and are at . It is recommended to include images or figures to celebrate good practice within your organisation (for example a figure demonstrating reduced antibiotic prescribing in your local trust) to share with colleagues.

A range of– produced by the Veterinary Medicines Directorate – are also available for use. See Figure 6 for an example.

We encourage use of the message style that is most suited to your organisation. The format will allow adaptation for local messages.

Figure 5. Examples of the digital ‘thank you’ notes available for use duringWAAW

Figure 5 shows 3 examples of these digital notes, 2 with a blue background and one with a red background. Each image includes a yellow ‘sticky note’ style image in the centre, upon which the word ‘Thankyou’ is written in large text. Each note then follows with a specific message. The first blue note at the top left of the figure includes the NHS logo in the top right of the image. The red note at the top right of the figure includes the Antibiotic Guardian logo in the top right of the image. The blue images contain the hashtags #AntibioticGuardian and #KeepAntibioticsWorking at the bottom of the yellow sticky note and the red image contains just the #AntibioticGuardian. The blue image at the top left contains the message text ‘for thinking about antibiotic course length!’ after the large ‘Thankyou’ text, whereas this is followed on the red image by the text ‘for TARGETing patient information and safety netting when you treat infections’. The blue image at the bottom centre of the figure contains free space underneath the ‘Thankyou’ text for colleagues to enter their own message, as well as a space at the top right for colleagues to include their own logo.

Figure 6. An example of the Veterinary Medicine Directorate-produced One Health digital card, for use duringWAAW

Figure 6 consists of a blue box for silhouette images of a range of animals, fish, humans, and trees arranged in a ring in the centre. Within this ring reads the text ‘Together we can prevent antimicrobial resistance’. Text in the bottom left of the image reads ‘Choose a pledge and become an #AntibioticGuardian via. The Antibiotic Guardian logo is included in the top right, with theWHOWAAWlogo placed in the top left.

Guides for engaging with local communications team

Two quick guides have been produced to streamline local engagement with nationalWAAWinitiatives. The first is a guide to. Its purpose is to facilitate the collaboration of colleagues with their local communications professionals, to produce and release impactfulWAAWmaterials.

The second guide shows how to produce and share an organisationalWAAWvideo. We recommend that colleagues work with senior leaders, or within their own team to record and share a promotional video duringWAAW. We suggest the following video types, although you may wish to record other content ahead ofWAAW.

AMSpledge video

A short video from a senior leader to highlight the ongoing commitment to – and importance of – tackling AMR, including developing means to share this across your organisation.

Resource promotion video

A short video to highlight existingAMSresources and signpost to where users can find them.

‘Meet the team’ video

A short video to highlight current work in tacklingAMR, while showing the friendly faces of your organisation.

This, which provides suggested wordings and examples from previous years, is available online and a preview can be seen in Figure 7. These organisational videos can be shared using the organisation’s social media channels, intranet and/or staff newsletters. Please use the following hashtags when sharing:

  • AntibioticGuardian

  • KeepAntibioticsWorking

  • WAAW2025

  • ConfrontingAMR

Figure 7. Screenshot of the quick guide to recording organisational videos forWAAW

Figure 7 contains both pages of the quick guide shown side-by-side. Each page contains a 2-tone white and red background designed to align with the red and white pill motif used by Antibiotic Guardian and Keep Antibiotics Working campaigns.

The first page on the left of the figure contains 2 sections – the first is an introduction followed by a summary of the 3 message types that colleagues can choose from when recording a video.

The second section contains suggested wording for colleagues to use when scripting their videos. On the second page – on the right of the figure – a further 2 sections are included. The first section provides a range of tips and suggestions for recording the videos. The second section contains examples of videos shared in 2020, with links to tweets and screenshots of the videos included.

A teleconference background has been developed for use duringWAAWand beyond. This has been developed to include key messages that align with theWAAWthemes cited earlier in the toolkit. The ‘red and white pill’ design has been used for this background, to align with otherWAAWresources used in England, as well as the Antibiotic Guardian campaign. This background is designed to spark conversation when in virtual meetings.

Acan be found online, alongside ‘Antibiotic Guardian’ and ‘Keep Antibiotics Working’ general backgrounds, which can be used at any time.

A blue version of the teleconference background has been designed to align with the ‘Go blue forAMR’ day organised byWHO. For more information, seeAppendix 1. Acan be found online.

Figure 8. Example of a teleconference background

This image contains a 2-tone white and red background designed to align with the red and white pill motif used by Antibiotic Guardian and Keep Antibiotics Working campaigns. The Antibiotic Guardian and Keep Antibiotics Working logos are included in the top left of the image. At the bottom left of the image, the text ‘World Antimicrobial resistance Awareness Week’ is included in large black text, with the first letter of each word shown in larger lettering in red to highlight the abbreviation. This text is followed by ‘18 to 24 November’ beneath it, to mark the date of the week. At the bottom right of the image, the text ‘Contact me to find out about resources available for tackling Antimicrobial Resistance’ is included in white. At the top right of the image, white text reading ‘Don’t let antibiotics go viral. Cold, COVID-19 or flu? Then antibiotics won’t help you’ is included.

Global X relay (formerly Global Twitter relay)

Each year for the last 4 to 5 years, there has been a 24-hour Global X relay in collaboration with US CDC,ECDCand others on 18 November. The set time for the UK will be published closer to the date. Please continue to post on social media at any time but we encourage colleagues to post on X using theat the start of the UK designated time, then your choice of additional messages for the rest of the hour. SeeFigure 9for the Global X relay tweet card.

Global X relay message:

Antimicrobial Resistance is one of the most urgent global threats to the public’s health. Antibiotics can cause side-effects, including nausea and diarrhoea and contribute to the development of #AntibioticResistance #AntibioticGuardian #KeepAntibioticsWorking #WAAW

ThisX relay is anopportunity for colleagues to focusdissemination ofAMS-related messagesand/or relatedimages on the X platform and other social media accounts.

To add an Xrelay reminder to your Outlook calendar,you can.

In addition to the joint message and tweet card, there areavailable for use.

Social media posts can be prepared ahead of time and set to be published at a pre-determined time, in case you are busy during the hour of the X UK relay. To schedule a post on the X app, click the calendar icon in the X post box once you have created your post to open the ‘Schedule’ box, you can then set the date and time that your tweet will be released, before clicking the ‘Confirm’ button. For more information, contact your local communications team.

Colleagues are encouraged to use the following hashtags when taking part in social media activity duringWAAW:

  • AntibioticGuardian

  • KeepAntibioticsWorking

  • WAAW2025

  • ConfrontingAMR

Figure 9. The X card available for use during the global X relay

Figure 9 includes a logo forUKHSAat the top left and a logo for the ‘Antibiotic Guardian’ and ‘Keep Antibiotics Working’ campaigns at the bottom left, above 3 hashtags in a maroon footer box (#AntibioticGuardian, #KeepAntibioticsWorking, #WAAW). An image of a pile of red and white antibiotic pills is placed next to the Antibiotic Guardian logo and a QR code for the Antibiotic Guardian website is placed above the pill image. To the left of the QR code reads the text ‘#AntimicrobialResistance is one of the most urgent global threats to the public’s health. Antibiotics can cause side-effects, including nausea and diarrhoea and contribute to the development of #antibioticresistance’.

Resources for public awareness campaigns

Keep Antibiotics Working and Antibiotic Guardian campaigns

In 2014,PHE developed the Antibiotic Guardian campaign and associated resources to provide educational resources to help tackleAMRin the UK. This was in collaboration with the Department of Health (now Department of Health and Social Care), Veterinary Medicines Directorate (VMD), the devolved administrations, local government, and professional organisations.

The impact and evaluation study of Antibiotic Guardian demonstrated that the campaign increased commitment to tacklingAMRin both healthcare professionals and members of the public, increased self-reported knowledge, and changed self-reported behaviour, particularly among people with priorAMRawareness.

are available for use.

In 2017,PHElaunched a national campaign Keep Antibiotics Working (KAW) across England to support the government’s efforts to reduce inappropriate prescriptions for antibiotics by raising awareness of the issue of antibiotic resistance and reducing demand from the public using TV, radio, and social media.

KAWraises awareness of antibiotic resistance amongst the general public and encourages greater trust in the advice from healthcare professionals when it comes to whether consumers need antibiotics or not.

Although the campaign has not actively run on TV and radio since 2019, the are still current and available to download and use. The were translated into 12 additional languages in 2022. See Figure 10 for examples.

Figure 10. Three examples of a Keep Antibiotics Working campaign poster

In Figure 10, from left to right, there are posters written in Urdu, Arabic and Polish. Each poster consists of a white background with a red border and an image of a red and white antibiotic pill, which has been split in half at the centre of the poster. An NHS logo is placed at the top left of the first 2 posters, and at the top right of the third. The ‘Keep Antibiotics Working’ logo is placed at the bottom right of the first 2 posters, and at the bottom left of the third.

The messages have also been used to develop multilingual videos in a project led by UCL School of Pharmacy. The link to the playlist is available , and the project features messages in the following languages: Arabic, English, Portuguese, French, Mandarin, Cantonese, Pashto, Persian, Polish, Punjabi, Spanish, Ukrainian, Urdu, Gujarati. Examples of the videos are available in Figure 11.

Figure 11. Five examples of WAAW multilingual videos

Chapter 6 Professional and public education, engagement, and training of the ESPAUR report shares some highlights of how to engage the public, sharing case studies as well as reviewing the success of the campaigns through data.

Antibiotic amnesty resources

Resources for organising aare hosted on the Royal Pharmaceutical Society website. This initiative encourages individuals to safely dispose of unused or leftover antibiotics in collaboration with community pharmacies and veterinary practices.

Resources aimed at engaging with children and young people

Intravenous-to-oral switch (IVOS)

UKHSApublished theNational criteria for prompt intravenous-to-oral switch (IVOS) of antimicrobials in children and young people (including newborns).

UK Paediatric Antimicrobial Stewardship (UK-PAS) network

ճUK-PASnetwork has a, including theUK-PASantimicrobial prescribing guide Antimicrobial Paediatric Summary.

ճUK-PASnetwork’s mission is to create a network of health professionals to share lessons learned from appropriate antimicrobial use and to conduct local, regional and international projects destined to ensure safe and effective use of antimicrobials in neonates, children and young people and help address the spread of antimicrobial resistance.

Infographics and leaflets

Awith the main messages on appropriate antibiotics use in children with coughs and sore throats have been produced by the University of Oxford in collaboration with the National Institute for Health and Care Research and families with children.

ճ(Polar Bear) leaflet here has been co-produced with parents to facilitate self-care.

Supporting children to take their medicine:

Most children over the age of 4 can be taught to swallow tablets and capsules. The following resources support parents to educate children to do this:

The following actions can also be taken by HCP

  • encourage patients to return unused medicines to a pharmacy
  • never share or keep unused medicines
  • consider the use of soluble tablets when prescribing for children

e-Bug

Educational resources to run engaging activities and sessions on microbes, infection and antibiotics for ages 3 to 16. All activities and lesson plans are designed to complement the National Curriculum and can be adapted to meet the needs of your group.

Antibiotic Guardian Schools Ambassadors

Through the Antibiotic Guardian Schools Ambassadors programme, public health and healthcare professionals, vets, vet nurses and scientists are invited to connect with local schools and community groups. Ambassadors are encouraged to provide a teaching session, promote a toolkit of lesson planning resources, and/or provide an article on important public health topics such as microbes, hygiene, infection prevention and antibiotics for schools to include in their newsletter.

Further information on the programme and registration is available on the. The toolkit and newsletter item resources will be provided automatically to those that register to become an AG Schools Ambassador.

Tools for Schools

The ‘Tools for Schools’ toolkit provides links to free, quick and easy-to-use resources for local authorities, and those who work with children, to coordinate local antimicrobial awareness campaigns for children and young people. It includes links to a variety of resources for engagement with educators, children, parents, carers, healthcare professionals, and the public for use during WAAW and beyond.

The toolkit was developed in partnership with East of England teams in NHS England, integrated care boards (ICBs), local authorities. Sources include e-Bug, UKHSA WAAW resources, UKHSA Antibiotic Guardian resources, NHS Health Education for England eLearning for Health, Imperial College London Health Protection Research Unit, the Seriously Campaign, and the UK Paediatric Antimicrobial Stewardship (UK-PAS) network. Each page contains resources for a specific group who work with CYP.

The ‘Tools for Schools’ toolkit can be accessed on our Knowledge Hub .

AdditionalAMRresources, toolkits and wider activity

Toolkits and resources

Previous versions ofWAAWorEAADtoolkits

WAAWorEAADtoolkit, including versions from previous yearsare available online.

Quizzes and crosswords

You can have a virtual competition or sharequizzes and crosswordsvia your organisation or school newsletter.

AMSgame

ճis an educational game for healthcare professionals, this exploresAMSԻAMR; it is available as a face-to-face (board game) and online versions. The 4 broad areas addressed in the game are:

  • introduction toAMRand stewardship
  • appropriate use of antimicrobial agents
  • infection prevention and control
  • stewardship and surveillance

The game can be played by all members of staff, including:

  • doctors
  • nurses
  • pharmacy teams
  • veterinary teams
  • laboratory staff
  • other clinical staff
  • support staff
  • cleaners and porters
  • students

– which was co-created by a multidisciplinary team of health professionals spanning across high- and low-to middle-income countries – is available online.

Figure 12. AMSgame in both physical and virtual format

Figure 12. is split into 2 images. The image on the left shows a physical version of the boardgame, which sits in front of its box. On the right, there is an image of an individual using a laptop, with an online version of the game on the screen. In both images, the game takes the form of a 10 by 10 grid board, with alternating blue and purple squares.

Posters and leaflets

Posters and leafletsare available for the public and healthcare professionals to support antibiotic awareness campaigns in the UK.

Patient story videos

can be shared as part ofWAAWcampaigns. There are a range available via , and websites

‘Start smart then focus’ toolkit

Start smart then focus(SSTF) is a toolkit of evidence-basedAMSresources for the secondary healthcare setting. The competencies and algorithms were updated using a stepwise and systematic approach and were subsequently published on 12 September 2023.

It is recommended that healthcare organisations should monitor adherence to theSSTFprinciples regularly in all clinical areas (at least annually) and, in England, evidence adherence to the Code of Practice, developing an action plan for improvement as required.

Penicillin Allergy De-Labelling (PADL)

Around10% of patients in the UK report a penicillin allergy, yet studies show thatover 90% of these labels are incorrect. Mislabelled penicillin allergies can lead to the use ofless effective, broader-spectrum antibiotics, increasing the risk of AMR, treatment failure, and healthcare-associated infections such asClostridioides difficile.

Why it matters:

  • patients labelled as penicillin-allergic are often prescribedsecond-line antibiotics, which may be broader-spectrum and less targeted
  • these alternatives can beless effective, cause more adverse effects, and contribute to the development ofantimicrobial resistance (AMR)
  • structured allergy assessmentsand appropriate de-labelling can optimise antibiotic use,improve patient safety, and helppreserve the efficacy of first-line treatments

Find out more on .

Secondary care prescriber’s checklist

Prescribers in secondary healthcare can use theprescribing antimicrobials checklistto help make decisions about prescribing antibiotics. This checklist was updated in September 2023, and is an updated version of the resource previously published in theSSTFtoolkit.

IV to oral switch criteria

IV to oral switch criteriafor adults, children and young people, are available to support early switching from intravenous to oral antibiotics, co-produced through a UK-wide consensus process.

Antibiotic Review Kit

ճholds a range of resources designed to help all healthcare professionals to reduce antibiotic overuse in hospitals.

Dental toolkit

ճdentalAMStoolkithelps primary care practitioners promote the appropriate use of antibiotics in dental care.

Antimicrobial and prescribing stewardship competencies

ճantimicrobial and prescribing stewardship competenciesfor all independent prescribers to help improve the quality of prescribing practice are available on ֱ. ճantimicrobial prescribing and stewardship competency frameworkwas updated and published in August 2023.

Wider activities and resources

European Centre for Disease Prevention and Control resources:

, particularly on 24 November. This can be supported through online presence, physical communities, and workplaces. Find out more inAppendix 1.

Infection Prevention Society’s.

WAAWorEAADnational planning group

The nationalWAAWor EEAD planning group meets biannually to discuss national plans forWAAWorEAADand share learning. The group is chaired by Dr Diane Ashiru-Oredope,UKHSA.

The planning group had representation from:

  • all UK nations
  • UKHSAteams (includingAMRProgramme Board, e-Bug, TARGET, Behavioural Insights)
  • NHS England
  • British Society for Antimicrobial Chemotherapy (BSAC)
  • Centre for Postgraduate Pharmacy Education (CPPE)
  • Royal Pharmaceutical Society (RPS)
  • Veterinary Medicines Directorate, Department for Environment, Food and Rural Affairs (DEFRA)
  • National Institute for Health and Care Excellence (NICE)
  • British Dental Association (BDA)
  • Leeds GP Confederation
  • Regional Antimicrobial Pharmacists Network

The resources for WAAW are developed through a multidisciplinary subgroup which has been led by Dr Louise Dunsmure (2020), Fran Garraghan (2021 and 2022) and, in 2023 to 2024, Rakhi Aggarwal. Several resources were updated through the WAAW national planning group in 2025.

Health disparities and inequalities

One of the underlying threads for theWAAWdaily themes is on addressing health disparities and inequalities which links to outcome 8 (health disparities and health inequalities) of theNAP. Aundertaken byUKHSAfound evidence showing influence of factors commonly known to be associated with health inequalities, such as age and deprivation, on both antibiotic use and antibiotic-resistance infections in high-income countries.

Health inequalities are a universal problem, however, the extent to which certain factors influence the disparities in health vary by country. The review highlighted the influence of race or ethnicity, and antibiotic use was particular to country context. The review found that those in older age groups, particularly in residential care settings, had the highest antibiotic use, and areas of high deprivation had higher antibiotic use compared with areas of no or low deprivation. Furthermore, learning disability has been shown to be a strong predictor for development of sepsis (Zhong and others 2024).

Healthcare professionals, including those in the pharmacy profession, are ideally placed in community and hospital settings to raise awareness of how inequalities impact infection management and resistance rates, as well as advocating for equity of access in Core20PLUS5 populations.

Using theare a great way to reach out to certain populations and vulnerable groups to provide information that is clear and concise and can encourage conversations and raise awareness ofAMR.

These messages are included in the.

As part of the deliverables for UKAMRnational action plan 2024 to 2029,UKHSAwill be working with partners to develop a toolkit to support tackling health disparities inAMR.

For resources available online see .

Appendix.WHOWAAWcampaign

World Health Organization’s (WHO’s) theme for the World AMR Awareness Week (WAAW) 2025 is “Act Now: Protect Our Present, Secure Our Future” ’. This theme underscores the urgent need for bold, coordinated, cross-sectoral action to address AMR, a growing global threat that is already affecting our health, food systems, environment and economies.

The slogan ofWAAWremains ‘Antimicrobials: Handle with Care’.are available from their campaign website. Launched in May 2024, the World Health Organization’s campaign puts advocates front and centre to share their stories, raise awareness and urge action to address AMR.

The 2024 UN General Assembly High-level Meeting on AMR and the fourth Global High-Level Ministerial Conference on AMR, for instance, provide a critical window of opportunity for political and financial commitments as well as increased accountability in response to AMR. Stronger political leadership, advocacy and accountability are needed at all levels and the time to act is now.

WHOis encouraging the global community to ‘Go blue forAMR’, particularly on 24 November. This can be supported through online presence, physical communities and workplaces., including a toolkit, can be found online. Andesigned to align with the ‘Go blue forAMR’ day is shown in Figure 13. An example of ‘Go blue forAMR’ activities being advocated on social media is shown in Figure 14.

Ways to join the campaign

Individuals can:

  • wear light blue when participating inWAAWevents
  • adjust your social media profiles to blue
  • share why you are ‘Going blue’ with friends, family, colleagues, and on social media (for example, “I’m Going blue in honour of my uncle, who contracted a drug-resistant infection following hip surgery” or “As a doctor, I’m ‘Going blue’ to spread awareness among my colleagues about responsible antimicrobial prescribing”)

Workplaces or organisations can:

  • light up one health stakeholder facilities (human and animal hospitals, clinics, laboratory facilities, pharmaceutical headquarters, universities) in blue
  • combine this with workplace actions: create or reviewAMSprogrammes, educate staff onAMRand make a workplace commitment toAMR-related change
  • share with the world – use social or traditional media to announce why your workplace staff are going blue

Figure 13. Example of a teleconference background adapted for use duringWAAWas part of theWHO‘Go blue forAMR’ day on the 24 November.

Figure 13 contains a 2-tone white and blue background. The Antibiotic Guardian and Keep Antibiotics Working logos are included in the top centre of the image with theWHO‘Antimicrobial – Handle with care’ logo below it. To the left of these 2 logos, text ‘World Antimicrobial resistance Awareness Week’ is included in large black text, with the first letter of each word shown in larger lettering in blue to highlight the abbreviation. This text is followed by ‘18 to 24 November’ beneath it – in blue – to mark the date of the week. To the right of the logos in the centre top of the image is the text ‘Go blue forAMR. Contact me to find out about resources available for tackling Antimicrobial Resistance’. The first sentence is in dark blue, with the subsequent wording in lighter blue.

Figure 14. Examples of social media posts forWAAWԻEAAD2022

Figure 14 shows a collage of 4 screenshots of former Twitter posts sitting side by side. Far left screenshot posted by Cheshire West of a bridge and clocktower in the background lit blue. Middle left screenshot posted by Lancashire and South Cumbria ICB is of Blackpool tower, a tall structure, lit up blue at nighttime, with a building visible in the foreground. Middle right screenshot posted by Gill Damant with 3 thumbnail images below some text, on the left a picture of a statue of Sir Tom Finney kicking a football over some water with a fountain in the background which are lit blue for Go Blue campaign. To the top right of this image is a smaller thumbnail of Preston North End Football Club stadium lit up in blue, below this is image on the bottom right is a wider angle shot of the same stadium lit up in blue lights with some trees and grass verge in the foreground. The far-right image is a screenshot of a post by Blackpool Gazette with Blackpool tower in the background during the daytime and a fairground ride in the foreground, with the text ‘Why Blackpool tower will light blue (spoiler, it’s a micro reason)’.

Public feedback on Go Blue campaign

Research was conducted by the international insight consultancy, Basis, to determine the awareness and impact of supportingWHO’s ‘Go blue forAMR’ campaign. The research focused on the local area of Blackpool to understand the reaction to local activity, including lighting up Blackpool Tower.

This research highlighted the importance of clear, impactful messaging for this campaign. A high number of people interviewed (94%) were aware of the tower being lit blue before they were interviewed, however the majority (64%) did not see any messages, and 3% of those interviewed thought the messages said ‘keep antibiotics working’.

Although 93% of those interviewed had an understanding of antibiotic usage, such as never sharing antibiotics with anyone else, around one in 5 had never heard ofWAAWweek.

Therefore, we encourage that throughout the Go Blue activities, to ensure that there are clear messages highlighting the reasons behind this, to ensure maximum impact on driving the key message and overall awareness ofWAAW.

EmailESPAUR@ukhsa.gov.ukfor more information on how we can help you with the Go Blue campaign.