Only a minority of the surveyed experts consider spectacular estimates such as those of the British O’Neill Commission (https://amr-review.org/), which expects 10 million deaths annually as of 2050 to be resilient. Markus Lehmkuhl, a professor of science communication in digital media at KIT and Freie Universität, conducted an online survey of 375 researchers worldwide. The surveyed researchers had published relevant studies in international journals during the past three years. Coinciding with World Antibiotic Awareness Week, international organizations such as the World Health Organization (WHO) are calling on individuals to help raise public awareness of antibiotic resistance.

"The uncertainty in the quantification of the fatalities is due to considerable disagreement among the scientists as to whether the number can be quantified with available scientific methods," said Lehmkuhl. Almost one-third of the respondents rated the reliability as low or very low, another one-third as high or very high. The remaining third did not want to comment.

The surveyed scientists all agree that countermeasures are urgently needed. Almost all of them (98.4 percent) fear serious or very serious consequences, if nothing should be done to prevent the spread of resistant pathogens. From the perspective of the experts, the two most sensible measures are to reduce the use of antibiotics in medicine and to improve hygiene in hospitals and clinics. Additional important factors are the reduction of antibiotics in livestock farming and the development of vaccines, alternative therapies, and new active substances against resistant bacteria.

In view of the challenges described, the survey respondents do not view the presentation of antibiotic resistance in the public as exaggerated. "About two-thirds of the respondents consider that dramatic phrases such as global 'catastrophe' or 'emergence of a post-antibiotic age' are more or less justified," says Lehmkuhl. He concludes that "The scientists are convinced that antibiotic resistance is very dangerous, but at the same time, due to methodological difficulties, they are not able to provide robust figures. In order to draw attention to this important area of action, most of the respondents believe that an alarming vocabulary is justified because they assume the media will react accordingly." This of course can lead to a kind of public overbidding discourse, in which whoever names the highest number of fatalities or describes the most terrible scenarios is most likely to be heard.

The survey is part of the joint project "Rational Use of Antibiotics through Information and Communication" (RAI), which is coordinated by Charité - Universitätsmedizin Berlin and funded by the German Federal Ministry of Research. The involved scientists are dedicated to the topic of antibiotic use and the development of resistance. In addition, Lehmkuhl's subproject aims to create a survey tool that allows as many experts as possible to be interviewed on a topic at once, for example, by journalists. "The level of knowledge is now so large and differentiated that individuals can no longer represent it," says Lehmkuhl, who would like to follow the example of climate research and tap into the expertise of the global science community. The 375 experts surveyed on antibiotics represent about 2,500 researchers worldwide who have published studies on antibiotic resistance in international science journals. About 15 percent of all the scientists working in the field were surveyed. In order to be able to carry out similar surveys on other topics in the future, KIT is cooperating in the joint project RAI with the Science Media Center in Cologne. They are planning to develop a procedure whereby all the experts of relevant disciplines can contribute selectively to the public discourse, for example, via a web portal, through which journalists can make a request to experts worldwide.

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