Overview

This lesson plan is for teachers, public health nurses, or health care students to use in a secondary school
classroom. The lesson includes interactive discussions with the students and activities. There are optional
activities for enhanced learning. The lesson plan is designed to be 45-60 minutes but can be adapted to fit your
needs.

Please report your teaching back to us as the number of students taught in BC is reported to the Ministry of
Health.

Please report teaching by visiting: antibioticwise.ca/report-teaching

Learning Outcomes
 Following this lesson, students will be able to:
 Describe the microbiome and differences between bacteria and viruses.
 Identify that antibiotics only work against bacterial infections, not viral infections.
 Discuss how antibiotic resistance develops, and how to use antibiotics wisely.
 Indicate ways to prevent the spread of infections, including proper handwashing and vaccinations.

How the lesson aligns with the BC Curriculum

Science Physical & Health Mathematics

Education
 Antibiotics &  Reasoning using
superbugs  Healthy living percentages
 Vaccines prevent  Health choices &  Compare &
disease health effects interpret data
 Community
contribution

Acknowledgements
The Antibiotic Wise program would like to thank Komal Adeel for her contributions to the creation of this lesson
plan and associated materials.

For more lesson plans and teaching resources, visit antibioticwise.ca/teaching

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Activity 1: Bacteria, Viruses, and the Microbiome
Length: 15 minutes
Materials: Worksheet #1 printed for each student, computer and projector for PowerPoint slides and optional video.
PowerPoint Slides: If using the prepared slide deck, this section will go through slides 1-10

This section starts with an introduction to the microbiome. Ask students if they know what the microbiome is.
The microbiome is all of the living organisms, such as bacteria, viruses, and fungi, that are found in and on our
body.

Emphasize that bacteria can be helpful or harmful to humans. Helpful (or good) bacteria are called
commensals. They can help in digestion of foods, and can compete with bad bacteria and prevent infections.
Harmful (or bad) bacteria are called pathogens.

 Ask students to list similarities and differences between bacteria and viruses. (Worksheet #1). If they
don’t know any differences, provide examples from the answer key (page 5).

 Ask students if they can think of any illnesses caused by bacteria? Illnesses caused by viruses?
(Worksheet #1). Students can guess, or look it up on the internet if time permits. Write answers on
the board.

 Ask students what antibiotics are? Ask if they or anyone in their family ever taken antibiotics? Review
that antibiotics are a class of medications that are specifically designed to kill bacteria. They do not
work against viruses.

 As an example, ask students if they have ever heard of an antibiotic, for example penicillin.
Antibiotics like penicillin are designed to attack the cell wall of bacteria. Based on our discussion on
the difference between viruses and bacteria, would penicillin work against viruses? (No, because
viruses do not have cell walls).

 Return to the list of illnesses caused by bacteria vs. viruses. Antibiotics can only be used for the
illnesses that are caused by bacteria. They should not be used for illnesses caused by viruses.

Optional Video “Good Germs vs. Bad Germs” (2:54 mins)

youtu.be/qDluMg9lqn8

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Worksheet # 1 Name: ________________________________________

Bacteria and Viruses

Bacteria Similarities Viruses

Illnesses caused by viruses Illnesses caused by bacteria

Word Bank
• Common cold • COVID-19 • Pertussis
• Strep throat • Tuberculosis • Meningitis
• Salmonella • Urinary tract infections (UTIs) • HPV
• Influenza (Flu) • Chicken pox • Most sore throats

1. Antibiotics can work for illnesses caused by bacteria. True False

2. Antibiotics can work for illnesses caused by viruses. True False

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Answer Key # 1 Name: ________________________________________

Bacteria and Viruses

Bacteria Similarities Viruses

• Have a cell wall • Bacteria and • Are acellular

• Are living viruses are • Need to enter a
organisms both host cell to
• Our bodies need microscopic. replicate
good bacteria to • Bacteria and • Our bodies do
function (for viruses can not need viruses
digestion, for both cause • Antibiotics do
protection on illnesses. not kill viruses
our skin, in our
mouths)
• Antibiotics kill
bacteria

Illnesses caused by viruses Illnesses caused by bacteria

• Common cold • Strep throat

• Influenza (Flu) • Tuberculosis
• Chicken pox • Urinary tract infections (UTIs)
• HPV • Salmonella
• Most sore throats • Pertussis
• COVID-19 • Meningitis

Word Bank
• Common cold • COVID-19 • Pertussis
• Strep throat • Tuberculosis • Meningitis
• Salmonella • Urinary tract infections (UTIs) • HPV
• Influenza (Flu) • Chicken pox • Most sore throats

1. Antibiotics can work for illnesses caused by bacteria. True False

2. Antibiotics can work for illnesses caused by viruses. True False

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Activity 2: Antibiotic Resistance
Length: 20 minutes
Materials: Worksheet #2 printed for each student, computer and projector for Powerpoint slides and optional video.
PowerPoint Slides: If using the prepared slide deck, this section will go through slides 11-27

 Why is it important to use antibiotics correctly? Improper use of antibiotics can lead to antibiotic resistant
bacteria (i.e. superbugs). Ask students if they know what this means.

 Review how antibiotic resistance develops: Bacteria are always randomly mutating. Sometimes, they will
randomly develop a mutation that makes them resistant to antibiotics. Normally, the helpful (or good)
bacteria in our body take up space and prevent the few resistant bacteria from taking over. When we overuse
antibiotics, we kill the helpful (or good) bacteria. The resistant bacteria survive and have lots of space to
multiply and grow. This is natural selection.

 Discuss how antibiotics are needed for modern medicine – surgery, childbirth, transplants, burn therapy,
cancer treatments (and most modern medicine) relies on antibiotics to treat or prevent infections. Before
antibiotics existed, people could die even from infected cuts and scrapes.

 When antibiotics are used too much or incorrectly (for example if they were used for treating viral infections),
bacteria causing you to be sick may no longer respond to the drug and you may continue to be sick. “To
preserve antibiotics for the future, it’s our job to limit our use of antibiotics, to make sure we are using them for the
right reason, so that they work when we really need them.”

 Have students get in small groups to work on Worksheet #2 (page 7).

 Review Worksheet #2 with the class using Answer Key #2 on page 8. Emphasize that although every
time we use antibiotics there is a risk of bacteria developing resistance, we want to combat this by
using antibiotics correctly and for the right reason, not avoiding them entirely, because antibiotics
can be helpful and even life-saving in many situations.

 Ask students how we can prevent antibiotic resistance. Use the following prompt: “If you were at the
doctors’ office, what questions could you ask to make sure you’re using antibiotics correctly?” (Do I have a
bacterial infection or a viral infection? Do I need antibiotics? How long do I need to take these
antibiotics for?)

Optional Video “Antibiotic Resistance and the Rise of Superbugs” (7:23 mins)

youtu.be/fyRyZ1zKtyA (watch until 6:45)

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 Worksheet # 2 Name: ________________________________________

Terry’s Antibiotic Dilemma

Terry is feeling sick. He found some antibiotics in his medicine cabinet. What could happen if:

Terry took the antibiotics Terry took the antibiotics Terry went to the doctor
and his illness was caused and his illness was caused and was prescribed
by a virus by a bacteria antibiotics

Would Terry
feel better?

What would
happen to the
good bacteria in
his body?

Is there a
chance of
resistance
developing?

Should Terry
take the
antibiotics?

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 Answer Key # 2 Name: ________________________________________

Terry’s Antibiotic Dilemma

Terry is feeling sick. He found some antibiotics in his medicine cabinet. What could happen if:

Terry took the antibiotics Terry took the antibiotics Terry went to the doctor
and his illness was caused and his illness was caused and was prescribed
by a virus by a bacteria antibiotics

Would Terry No, because the antibiotics Most likely not. The Yes
feel better? will not kill the virus antibiotics may or may not
work against the specific
bacteria he is infected with,
and they could be expired.

What would Some of the good bacteria Some of the good bacteria Some of the good bacteria
happen to the in his body would die. in his body would die. in his body would die.
good bacteria in
his body?

This is why a common side effect of antibiotics is an upset

stomach (remember, good bacteria help with digestion). However,
if he takes antibiotics correctly and only as long as prescribed by
his doctor, his good bacteria will have a chance to bounce back.

Is there a Yes – when good bacteria Yes Yes

chance of die, resistant bacteria can
resistance take over
developing?

Should Terry No – they will not help with No – they may not be the Yes – even though there is
take the his illness and may cause correct antibiotics for his a small chance of
antibiotics? resistance to develop. illness. Some bacterial resistance, we want to use
infections don’t even need antibiotics when we need
antibiotics because they get them so that illnesses don’t
better on their own. Don’t spread or get worse.
use old antibiotics!

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Activity 3: Illness Prevention
Length: 20 minutes
Materials: Worksheet #3 printed for each student, computer and projector for Powerpoint slides and optional video.
PowerPoint Slides: If using the prepared slide deck, this section will go through slides 28 to the end of the slide deck

 Another important way we can prevent antibiotic resistance is by preventing the spread of infections – if we
don’t get sick, we don’t need antibiotics in the first place!

 One way to prevent infections is to practice good hand hygiene. This includes handwashing, hand drying, and
choosing the right product to clean your hands.

 Drying your hands is a very important step of hand hygiene, as wet hands actually transmit germs better
than dry hands, and drying your hands removes 42% more germs than washing alone. Some hot air dryers
actually promote the growth of bacteria, as bacteria like warm places, so it’s best to use clean towels or paper
towels when possible.

 Both soap and water and alcohol-based sanitizers can be used to clean your hands. Soap and water is good
because it gets rid of bad bacteria and viruses, but good bacteria are not as easily removed. However, if you
do not have access to water or a way to dry your hands, alcohol-based sanitizers are a good option. Alcohol-
based sanitizers kill good bacteria as well as bad bacteria. Alcohol-based sanitizers are also not effective if
your hands are greasy or visibly dirty – you must use soap and water.

 Alcohol based sanitizers and plain soap do not cause bacteria to develop antibiotic resistance. However,
some sanitizers and soaps have ingredients that are antibacterial agents, such as triclosan or quaternary
ammonium compounds (quats). These can promote resistance, and can remove good bacteria. Products
labelled “antibacterial” usually have these agents. These products should be avoided as they are not needed
to achieve good hand hygiene.

 Have students get in small groups to work on Worksheet #3 (page 10) titled: “How can we prevent
infections?” If students have a difficult time thinking of ideas, prompt them with hints such as – what
are ways to stay healthy, or to prevent others from getting sick when we are sick?

 Optional activity:
Bring any of the following: hand soaps, alcohol-based sanitizers, antibacterial sanitizers, and/or
toothpaste. Pass them around to student groups. Ask students if they can find any “ingredients to
avoid” in the label, such as triclosan or quats, or signs that the product is appropriate to use (ex.
“triclosan free” label, alcohol-based ingredients like ethanol). Alternatively, ask students to try this at
home and check the products they use.

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Worksheet # 3 Name: ________________________________________

Brainstorm: How can we prevent infections?

1. Which hand hygiene methods are appropriate to use?

Soap and water Yes No

Alcohol-based sanitizers Yes No

Soaps and sanitizers with triclosan Yes No

Soaps and sanitizers with quats Yes No

2. What vaccines are routinely given in Grade 9 in BC? You can use the internet for
research.

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Answer Key # 3 Name: ________________________________________

Brainstorm: How can we prevent infections?

Wash your hands frequently

• Use soap and water or alcohol-based sanitizers, NOT antibacterial agents
• Always remember to dry your hands, preferably with a clean paper towel

If you are sick, protect others from getting sick

• Stay home when you are sick

Stay up to date with vaccines (if you don’t get sick you don’t need an antibiotic)

Use antibiotics correctly

• Don’t take antibiotics for colds and flus (see Doctor if you are unsure)
• Only take antibiotics prescribed to you, following the doctor’s instructions.
• Dispose of any unused antibiotics (at a pharmacy)
• Don’t share antibiotics with anyone.

1. Which hand hygiene methods are appropriate to use?

Soap and water Yes No

Alcohol-based sanitizers Yes No

Soaps and sanitizers with triclosan Yes No

Soaps and sanitizers with quats Yes No

2. What vaccines are routinely given in Grade 9 in BC? You can use the internet for
research.

The routine grade 9 vaccine in BC are:

• Meningococcal quadrivalent conjugate vaccine
• Tdap vaccine (Tetanus, diphtheria, pertussis)

Some students may be offered other vaccines too if they haven’t received them before

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Summary
 Bacteria and viruses are different. They both can cause illness but only bacterial illnesses can be treated with
antibiotics.

 Use antibiotics wisely. Bacteria can become resistant to antibiotics, so ask your doctor how to appropriately
use antibiotics when they are prescribed to you.

 By preventing illness, we can minimize antibiotic use and stop the spread of superbugs. Handwashing with
plain soap is the best way to stop the spread of infection. Receiving your routine immunization and staying
home when you are sick also helps to stop the spread of infections.

Additional Activities for Enhanced Learning

 Watch the video on understanding the term microbiome.

“The Hidden World of Microbiomes” (3:12 mins)

youtu.be/MjhDRG-mQ7w

 Activity - Research a current news article on antibiotic resistance and how it has affected a person’s life
(Worksheet #4) (page 13).

 Activity – Modeling the Microbiome – Use math manipulatives to model changes in the microbiome after
taking antibiotics. See instructions and Worksheet #5 (pages 14-19).

 Activity – Create a visual representation of antibiotic resistance – newspaper article, cartoon, poster, or
PowerPoint presentation. See Worksheet #6 (page 20).

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Worksheet # 4 Name: ________________________________________

Antibiotic Resistance
Review: Antibiotics are medicines that can quickly help to heal some types of infections
caused by bacteria. When antibiotics are used too much or not used the right way, they
may not work anymore. This is called “antibiotic resistance”. Antibiotic resistance is when
the bacteria that are causing you to be sick, no longer respond to the antibiotic and you
continue to be sick. Antibiotic resistance is a defense mechanism of bacteria that allows
them to survive and multiply, even when an antibiotic is present.

Assignment
Research a current news article about antibiotic resistance and answer the following
questions. If possible, bring the article to class to share. You can look for an article from
on-line newspapers such as The Globe and Mail or The National Post, or at a credible
website such as: https://antimicrobialresistancefighters.org/

1. What type of infection is the article about?

2. In this article, how is antibiotic resistance impacting someone’s life?

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Instructions for Activity – Modelling the Microbiome
Length: 30 minutes
Materials needed: For each group of three students: one clear plastic bag, coloured dry pasta (per group: 25
pieces of green pasta, 30 pieces of yellow pasta, 45 pieces of red pasta), student instruction sheet and
worksheet. Note: you can use any material other than dry pasta that you have available. Dry beans or math
manipulatives would also work.

 Watch the video to help understand the term microbiome.

“The Hidden World of Microbiomes” (3:12 mins)

youtu.be/MjhDRG-mQ7w

 Instructions for teacher to provide to students: “You will work in groups of three to model what happens to the
microbiome (bacterial composition within the body) with antibiotic use. You will use coloured dry pasta in a clear
bag. Each piece of pasta represents a bacterium. The different colours of pasta are representing different types of
bacteria. There are many more than three types of bacteria in your body, but we will use three for today’s exercise.”

 Hand out Worksheet #5 and tally sheet to each group of three students. Let the students know they can
use calculators for this exercise. Have students get dry pasta and plastic bag for their group.

 After students have completed the exercise, review together as a group.

 There are comprehension questions for deeper understanding on page 18 (Worksheet #6) and an answer
key on page 19. This can be done as a group activity or as homework.

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Worksheet # 6 Name: ________________________________________

Comprehension Questions: Modelling Resistance

1. Did the percentage of antibiotic resistant bacteria become higher or lower over time?

2. What did you notice about how the amount of good bacteria changed over time?

3. Did it help Marisa to take her father’s old antibiotic (antibiotic B) when she had a viral infection? How did
it effect the amount of bacteria in her body?

4. Luckily, the antibiotic resistant bacteria in the body weren’t causing an infection. What would happen if
the antibiotic resistant bacteria caused an infection?

5. How can we help preserve antibiotics for future generations?

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Answer Key # 6 Name: ________________________________________

Comprehension Questions: Modelling Resistance

1. Did the percentage of antibiotic resistant bacteria become higher or lower over time?

The percentage of antibiotic resistant bacteria increased over time.

2. What did you notice about how the amount of good bacteria changed over time?

The microbiome had fewer good bacteria and more harmful bacteria.

3. Did it help Marisa to take her father’s old antibiotic (antibiotic B) when she had a viral infection? How did
it effect the amount of bacteria in her body?

No, the antibiotic did not help Marisa as antibiotics don’t kill viruses. It could also be dangerous to take medication
that is not prescribed to you, you should only take antibiotics that are prescribed to you.

The antibiotic then killed her good bacteria.

4. Luckily, the antibiotic resistant bacteria in the body weren’t causing an infection. What would happen if
the antibiotic resistant bacteria caused an infection?

If Marisa had an infection with antibiotic resistant bacteria, the infection would be much more difficult to treat.
Sometimes antibiotic resistant infections are impossible to treat.

5. How can we help preserve antibiotics for future generations?

Stay up to date with vaccines (if you don’t get sick you don’t need an antibiotic).
Wash your hands frequently.
Don’t take antibiotics for colds and flus (see a doctor if you are unsure).
Stay home when you are sick (to not spread infections).
Understand that viruses and bacteria are different.
Don’t take antibiotics for a viral infection.
Only take antibiotics that are prescribed to you, and follow the written directions.
Don’t take antibiotics without a prescription.
Dispose of any unused antibiotics (at a pharmacy) and don’t share with anyone.

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