City Research Online

Abstract

Objectives
To synthesise evidence of antimicrobial resistance (AMR) educational initiatives for school-aged children and adolescents, evaluating global reach, pedagogical theory and impact.

Study design
A systematic literature review and narrative synthesis.

Methods
A systematic search of PubMed, SCOPUS and ERIC to March 2025, supplemented with an online open call to maximise global participation. Educational initiatives explicitly focused on AMR were included. Data extracted covered development, delivery, outcomes, pedagogical approaches, and evaluation. Risk of bias for published studies was assessed using ROBINS-I.

Results
119 educational initiatives from 44 countries (20 high-income and 24 lower middle-income settings) were included. The most prevalent delivery methods were the creation of lesson plans for educators (40%) or games (43%). The primary stated outcome of 101 initiatives was to improve knowledge of AMR. Individual constructivism (learner-centred) was the most common pedagogical approach. Forty-four initiatives evaluated change in AMR knowledge, all showing an improvement. Thirty were linked to regional educational curricula. Only three initiatives reported AMR-related intended or self-reported behaviour change. No initiatives had measured objective AMR-related outcomes.

Conclusion
AMR-focused educational initiatives for children and adolescents mainly focus on improving knowledge of AMR, not yet extending to enhancement of skills for behaviour change. The review is the first to include an open call for submissions, improving equity in reporting those activities not typically published in academic literature and contributes to the UN General Assembly recommendations of global collaboration and resource sharing for education. Future opportunities include innovation in pedagogy through participatory co-development with teachers and students.

Publication Type:	Article
Additional Information:	© 2026 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).
Publisher Keywords:	Antimicrobial resistance, Education, Public engagement, Antimicrobial stewardship, Public awareness
Subjects:	H Social Sciences > HN Social history and conditions. Social problems. Social reform L Education > LB Theory and practice of education Q Science > QR Microbiology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Population Health & Policy
SWORD Depositor:	Symplectic Administrator

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