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Education Campaigns Cut Antibiotic Use

Better public awareness may stem resistance to drugs

TUESDAY, Nov. 23, 2004 (HealthDayNews) -- Public education announcements get people to use antibiotics less frequently, a move that experts hope will help stem resistance to the drugs, a new study says.

Belgian researchers found that antibiotic use dropped by almost 12 percent during a flu-like outbreak that occurred after a public awareness campaign stressing the proper use of antibiotics.

The researchers report their findings in a research letter appearing in the Nov. 24 issue of the Journal of the American Medical Association.

"We consume too much antibiotics, mostly because we use them in situations where they may not be needed, [such as for viral infections like influenza]," said Dr. Paul Tulkens, a professor of pharmacology at the French Catholic University of Louvain in Brussels.

But, he added, "public campaigns help in curbing antibiotic sales in the community."

What isn't yet known, however, is how quickly a decrease in sales of antibiotics might affect the growing problem of antibiotic resistance.

"While resistance to antibiotics is undoubtedly linked to consumption, a change in resistance tends to be delayed, sometimes several years. To put things in perspective, it took almost 20 years of usage of penicillin to see the beginning of the emergence of resistance of Pneumococci towards this class of antibiotics. Sometimes, however, the change may occur much faster," Tulkens said.

For this study, the researchers organized two public awareness campaigns, which took place in 2000-2001 and 2001-2002. The campaigns lasted for three months, and the message was distributed through booklets, handouts, posters, Web sites and prime-time television ads.

Some of the messages included, "Save antibiotics, they may save your life," "Use antibiotics less frequently but better," and, "Talk to your doctor; talk to your pharmacist."

The population of Belgium is about 10 million, and according to Tulkens, the country is very similar in climate, education and economic status to an East Coast state in the United States.

After the first campaign, the researchers conducted a survey to see whether people had been paying attention to it. They had: 79 percent of those surveyed said that they remembered the campaign.

The researchers also tracked the number of antibiotic prescriptions sold, as well as the severity of flu and flu-like illness outbreaks each year.

"Many patients believe an antibiotic is needed in case of flu, and we see, indeed, a large increase in antibiotic sales during periods of influenza," Tulkens said. "If campaigns have any effect in curbing the inappropriate prescription and sales of antibiotics, this is the period where the largest change is to be expected."

From December through March of the first campaign, antibiotic sales decreased by 11.7 percent, according to the study, and during that same time frame in the second campaign, by 9.6 percent. Overall, Tulkens said the campaign resulted in a 13 percent decrease in the sale of antibiotics during the two-year study period.

"The message that people need to take from this study is that you should only take antibiotics for bacterial illnesses because they're only effective against bacteria, not against viruses," said Barbara Robinson-Dunn, technical director of the microbiology laboratories at William Beaumont Hospital in Royal Oak, Mich. Robinson-Dunn is also involved in the Michigan Antibiotic Resistance Coalition, a group that has also conducted successful public education campaigns that reduced unnecessary use of antibiotics.

"Just the fact that you have a fever doesn't mean it's not a virus that's making you sick. The consumer has to learn not to ask for or expect antibiotics for every illness, particularly for upper respiratory infections," Robinson-Dunn said.

She added that many people overlook an effective means of preventing illness in the first place: hand washing.

"Hand washing can cut down on disease very effectively," she said.

More information

To learn more about antibiotic resistance and proper use of antibiotics, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Paul M. Tulkens, M.D., Ph.D., professor of pharmacology, French Catholic University of Louvain, Brussels, Belgium; Barbara Robinson-Dunn, Ph.D., technical director, microbiology laboratories, William Beaumont Hospital, Royal Oak, Mich.; Nov. 24, 2004, Journal of the American Medical Association
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