We are really pleased to see research led by PhD student Brian Fenech featured this week in a recent article by Sophie Cousins for Medscape.

Last summer, Brian and Dr Daniel Gaffiero conducted a systematic review exploring the barriers and facilitators to antimicrobial stewardship in antibiotic prescribing and dispensing among GPs and pharmacists in Malta.

The review examined the complex realities influencing antibiotic-related decision making in healthcare settings. While awareness of antimicrobial resistance remains important, the findings highlighted a critical issue often overlooked in public health interventions: awareness alone is not enough to change behaviour.

Prescribing and dispensing decisions are rarely made in ideal conditions. Healthcare professionals operate under significant time pressure, diagnostic uncertainty, patient expectations, workload demands, and broader structural constraints within healthcare systems. As a result, interventions that focus solely on increasing knowledge or changing intentions are unlikely to produce meaningful or sustained changes in prescribing behaviour.

Instead, antimicrobial stewardship efforts must account for the wider behavioural, organisational, and systemic context in which decisions occur. This includes considering workflow pressures, communication dynamics with patients, professional norms, access to diagnostic support, and healthcare infrastructure.

It is encouraging to see this work contributing to wider international conversations around antimicrobial resistance and stewardship policy across Europe.

You can read the full Medscape article here