Antibiotic reduction can be achieved through low cost information campaigns, find researchers

A local low-cost information campaign mainly targeted at citizens and involving doctors and pharmacists can significantly decrease total antibiotic prescribing, finds a paper published today in BMJ.

The excessive is associated with resistance to these drugs and an increasing threat to . Antibiotics are also often unnecessarily and inappropriately prescribed. This is an issue that has been frequently addressed by health information campaigns.

Campaigns can be moderately effective in restricting the excessive use of although limits in study design make their evaluation difficult.

Italy has among the highest in Europe. There has, however, been a decrease in the last few years to coincide with two national information campaigns, but without direct involvement from health professionals.

Researchers from Italy therefore looked to evaluate the feasibility and effectiveness of a local information campaign, aimed at reducing by increasing awareness on threats of unnecessary use. They wanted to test the hypothesis that a campaign could be feasibly implemented within Local Health Authorities and reduce antibiotic prescriptions.

The study was a community level, : the campaign was implemented in the Italian provinces of Modena and Parma from 2011-2012. Provinces in the same region where no campaign had been implemented were used as the control group. The main target was the general population.

The material used in the campaign suggested that antibiotics are necessary in specific circumstances, do not work in the case of flu or colds and should be used when doctors prescribe them. The campaign motto was: "Antibiotics, solution or problem?". The following material was used: posters; brochures; videos in high accessed places such as pharmacies and ; two episodes of a talk TV show; radio segments; advertisements in ; web sites; and newsletters on antibiotic resistance directed at prescribers.

The main outcome was the average prescribing rate of antibiotics to outpatients during five months. Secondary outcomes included five month change in outpatient antibiotic expenditure per 1000 inhabitants / day and knowledge of, attitudes and reported behaviour about the campaign messages.

The average outpatient prescribing rates corresponded to decreases of 11.9% in the intervention area and 7.4% in the control area, compared with the same five month period of the previous year. The corresponding decrease in the rest of Italy was 3.2%.

A statistical model correcting for baseline differences found a 4.3%, statistically significant difference in between the intervention and the control area. This difference was not linked to any difference in hospital admissions, or to changes in knowledge and attitudes of the population. As for antibiotic expenditure, an estimate of its reduction ranges from € 200,000 to € 406,000 (€0.17 to €0.35 per resident).

The researchers say that the study shows the effectiveness of a local, small scale information campaign on antibiotics, carried out by local , and the potential advantage of local implementation such as involving doctors and pharmacists and adapting messages and tools to the local context. They say a "common lesson may be that large decreases in antibiotic prescription should not be expected, especially if a decreasing trend was already apparent since the previous years", but it is reassuring that the decrease in prescribing was "more pronounced than in the remaining parts of the country".

They conclude that reduced prescribing of antibiotics was "mediated by doctors' endorsement of the campaign goals and/or by an 'awareness of the campaign' factor, rather than by decreased patient pressure to get antibiotics". They add that change in people's knowledge and attitudes may require longer term exposure, but the availability of information, put in a proper context, could create a favourable climate for potentially relevant societal changes or changes in decision making even if that information does not influence the population directly targeted.

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Recorded Ebola deaths top 7,000

13 hours ago

The worst Ebola outbreak on record has now killed more than 7,000 people, with many of the latest deaths reported in Sierra Leone, the World Health Organization said as United Nations Secretary-General Ban ...

Liberia holds Senate vote amid Ebola fears (Update)

17 hours ago

Health workers manned polling stations across Liberia on Saturday as voters cast their ballots in a twice-delayed Senate election that has been criticized for its potential to spread the deadly Ebola disease.

Evidence-based recs issued for systemic care in psoriasis

Dec 19, 2014

(HealthDay)—For appropriately selected patients with psoriasis, combining biologics with other systemic treatments, including phototherapy, oral medications, or other biologic, may result in greater efficacy ...

Bacteria in caramel apples kills at least four in US

Dec 19, 2014

A listeria outbreak believed to originate from commercially packaged caramel apples has killed at least four people in the United States and sickened 28 people since November, officials said Friday.

Steroid-based treatment may answer needs of pediatric EoE patients

Dec 19, 2014

A new formulation of oral budesonide suspension, a steroid-based treatment, is safe and effective in treating pediatric patients with eosinophilic esophagitis (EoE), according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.