Table 3.

Responses to open-ended questions on antimicrobial resistance (AMR)

Question	Responses
Nightmare scenario	Global spread and dominance of totally antimicrobial resistant pathogens—returning to the preantibiotic era
Priorities for future research/policy	Environmental impact of antimicrobial use in humans, animals and crops Emerging bacterial resistance to biocides and disinfectants. AMR transmission from and to companion animals. Balancing food production capacity with AMR concerns. Need for comprehensive AMR surveillance; understanding the selection, expansion and spread of multidrug-resistant mobile genetic elements (mapping the mobile gene pool). Antibiotic stewardship—understanding why doctors prescribe and patients demand, antimicrobials inappropriately. Better infection control within health and aged care facilities. Point-of-care diagnostics (including rapid species identification and drug susceptibility testing). Use of highly selective bacteriophage therapy. Adaptive clinical trial designs for rapid assessment of multidrug regimens Alternative drug development funding models that considers the public good. Non-antimicrobial approaches to controlling infections.
Most important research question	Are there effective treatment strategies that will reduce selective pressure and on-going evolutionary ‘escape’, such as increasing bacterial susceptibility to immune attack or reducing the risk/impact of invasive bacterial infection only? What are the key characteristics of a healthy microbiome and the short and long term impacts of antimicrobial induced changes?
Issues that require public consultation	Restricting antimicrobial access to reduce inappropriate use, for example stronger regulation or increases in price How best to educate the general public and prescribers about the dangers (personal and environmental) of inappropriate antimicrobial use. Balancing animal and human welfare considerations. Balancing distributive justice and community versus individual cost–benefit.

AMR, antimicrobial resistance.