Antimicrobial resistance has been called a "silent pandemic," as it poses huge threats to public health while raising relatively little attention. To curb resistance, doctors must use antibiotics sparingly and responsibly — but the everyday pressures of medical practice can dissuade clinicians from prioritizing that goal. How can antibiotic stewardship be kept front of mind?

As a 2026 International Health Study Fellow for the Association of Health Care Journalists (AHCJ), I investigated the sociological and cultural factors that undermine antibiotic stewardship, especially in outpatient settings, where the majority of antibiotics are prescribed. Moreover, I explored tools that can help correct poor antibiotic use, and whether their effectiveness varies by cultural setting.

The resulting series draws comparisons between the United States and Japan, the latter of which rolled out a unique stewardship program that incentivizes better antibiotic use using small rewards of just 800 yen (about $5).

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​​​​​​This project was supported by AHCJ and

The Commonwealth Fund.