Flu season is unpleasant enough already, with an excess of sniffling and rubbish bins overflowing with tissues, it brings community health to the forefront of everyone's mind. But community health is more than hand-washing and vaccinations. The threat of antimicrobial resistance simmers beneath the surface.

Antimicrobial resistance is the biggest global crisis that no one is talking about. If unaddressed, drug resistant infections are predicted to be responsible for more deaths globally than cancer.
Antimicrobial resistance describes the development of a microbe's ability to survive treatment with an antimicrobial as a result of overuse. Usually, this demands higher doses—which are increasingly dangerous to the patient—or alternative types of antimicrobials—of which we're running on a low supply. Overuse of antimicrobials increases the propensity for bacteria—whether targets or bystanders—to become resistant, meaning if you are unlucky enough to catch a resistant infection, there's no cure.
With this threat looming over us, one would expect a tight rein on antimicrobials at the regulatory level. But in fact, we see the opposite. Antimicrobials can be found in consumer products ranging from toothpastes and deodorants to meats andcheeses. Furthermore, people aren't talking about it. Irresponsible or uninformed use of antimicrobials shortens the lifetime of effective treatments,ushering us ever faster toward a post-antibiotic era.
Much like the response to climate change, every individual can take steps toward amore sustainable relationship with antimicrobials to delay the onslaught ofresistant strains. To start this conversation with people in the community, graduate student Colleen McCollum founded the University of Colorado Boulderchapter of ARMOR, the Antimicrobial Resistance Mediation OutReach program, almost a year ago.

Working with other graduate students in her lab, Colleen organizes tabling and craft events (usually enticing passerby with free food) to set the scene for crucial conversations about how to use antimicrobials in an age where their efficacy is threatened.
At tabling events, ARMOR reps have conversations with community members about small steps they can take to stave off antimicrobial resistance. Things like finishing entire prescribed antibiotic courses, buying antibiotic-free dairy and meat, and using antimicrobial-free soap can make a huge difference in the community. Interactions usually go well, with folks being highly receptive to steps they can take, but CU ARMOR wanted to take it further.

"We can tell people to avoid using antimicrobial soap, but this event gives them an alternative right then and there," says Colleen. To reach an open audience, CU ARMOR teamed up with a residence hall on campus, Darley Hall, andinvited residents to make their own ARMOR-approved, antimicrobial-free hand soap.
"Residence halls house hundreds of students, all of whom share restrooms and community spaces; it's a petri dish of diseases. It's the last place you want to see antimicrobial resistance," warns Dana Stamo,co-founder of the CU ARMOR chapter.

For several hours on a Thursday evening, residents could walk in and make their own custom soap—liquid or bar—with hand-picked fragrances and shapes. All soaps are, of course, antimicrobial free, and come with individual ARMOR seals of approval. Colleen reports that students in attendance were open to a discussion of how to mitigate the development of resistant bacteria in their community. This made for great conversation while soaps hardened.

Withover 30 students who stopped by to make soap, the room smelled like a springtime meadow and the CU ARMOR team took comfort in the productive conversations prompted by the event. "We can rest easy knowing every student who stopped by will share this information with their friends or family and continue to spread the information," Colleen summarized.

CU ARMOR plans to host more soap-crafting nights in other residence halls at CUBoulder as well as an antimicrobial soap trade-in, where people can swap their antimicrobial-loaded soaps for more sustainable antimicrobial-free soaps. With more creative ideas in the works, CU ARMOR is on its way toward setting the scene for valuable conversations to raise awareness about this key challenge in community health.