Table 7 Coding scheme for content analysis on the representations of AMR risk

Headline framing on AMR

How AMR or AMR risk was labelled or interpreted in the headlines

Medical terms

The general medical terms such as antibiotic resistance, drug-resistant bacteria, or more specific medical term such as MSAR, multidrug-resistant Acinetobacter baumannii were used

Superbug

Superbug, superbugs or bacteria- or disease-specific superbugs such as super-gonorrhea was used to labelled AMR

Doomsday

The way AMR risk was labelled aimed to give alarming that AMR risk could lead to antibiotic apocalypse or post-antibiotic era when antibiotic of last resort became ineffective

Military term

AMR risk was labelled as a battle or war for which weapons were needed

Catastrophic

AMR risk was labelled as a crisis, disaster, global threat or something that was out of control

Cause and social actors

What cause AMR and who/what should be blamed for the problem of AMR

Misuse or overuse of antimicrobials

Misuse or overuse of antimicrobials particularly antibiotics including misuse or overuse of antimicrobials. The social actors for these can be sectors/individuals who were responsible for animal farming or health care, and the general consumers

Microbial evolution

The change of microbials themselves as a consequence of natural evolution was mentioned as the cause of AMR

Consequence

The consequences caused by AMR

Health consequences

Health consequences in humans due to AMR. This included sickness, infections becoming difficult to treat and death

Economic consequences

The economic loss due to AMR

Victims

Who was affected by AMR (whose risk is relevant). Two subcategories were found for this including vulnerable groups/individuals (patients, children or older people) or the general public (e.g. AMR affects AMR)

Controllability

Whether AMR can be controlled or not

Positive

The articles used a positive tone about the controllability of AMR such as words of “successfully harness”, “turning point”, and “hope” (of new solutions)

Negative

The articles presented a pessimistic tone about the controllability of AMR using words such as “fail” to treat, “untreatable”, “difficult to control” and “uncontrollable”

Solution

Technoscientific solutions

This includes discovery of new antibiotics, new treatments for resistant bacterial infections, and new technologies such as those that can be used to detect and kill drug-resistant bacteria in the environment

Appropriate antimicrobial use (AMU)

This emphasizes the importance of appropriate use of antimicrobials in humans and animals. It also includes those mentioned the importance of health education to raise people’s awareness of AMR risk and change their behaviours of antibiotic use

Political/organizational solutions

This emphasizes the responsibility of government or organization in the control of AMR. Solutions can be making policies to regulate antimicrobial use in humans and animals, strengthening surveillance of AMR and infection control, increasing funding for AMR research or control of AMR, or establishing new organizations for the control of AMR

Personal hygiene

This includes those emphasizing the importance of personal hygiene behaviours such as frequent handwashing, disinfection and avoiding close contact with animals

Others (e.g. vaccination, breastfeeding)

Other measures not included in the above such as vaccination and breastfeeding to promote personal immunity