Systematic review of public-targeted communication interventions to improve antibiotic use

Elizabeth Louise Anne Cross; Robert Tolfree; Ruth Kipping

doi:10.1093/jac/dkw520

journal article Open Access Dec 19, 2016

Systematic review of public-targeted communication interventions to improve antibiotic use

Elizabeth Louise Anne Cross Robert Tolfree Ruth Kipping

Journal of Antimicrobial Chemotherapy Vol. 72 No. 4 pp. 975-987 · Oxford University Press (OUP)

View at Publisher Save 10.1093/jac/dkw520

Abstract

Background: Excessive use of antibiotics accelerates the acquisition/spread of antimicrobial resistance. A systematic review was conducted to identify the components of successful communication interventions targeted at the general public to improve antibiotic use.
Methods: The databases MEDLINE, EMBASE, CINAHL, Web of Science and Cochrane Library were searched. Search terms were related to the population (public, community), intervention (campaign, mass media) and outcomes (antibiotic, antimicrobial resistance). References were screened for inclusion by one author with a random subset of 10% screened by a second author. No date restrictions were applied and only articles in the English language were considered. Studies had to have a control group or be an interrupted time-series. Outcomes had to measure change in antibiotic-related prescribing/consumption and/or the public’s knowledge, attitudes or behaviour. Two reviewers assessed the quality of studies. Narrative synthesis was performed.
Results: Fourteen studies were included with an estimated 74–75 million participants. Most studies were conducted in the United States or Europe and targeted both the general public and clinicians. Twelve of the studies measured changes in antibiotic prescribing. There was quite strong (P &lt; 0·05 to ≥ 0·01) to very strong (P &lt; 0·001) evidence that interventions that targeted prescribing for RTIs were associated with decreases in antibiotic prescribing; the majority of these studies reported reductions of greater than −14% with the largest effect size reaching −30%.
Conclusion: Multi-faceted communication interventions that target both the general public and clinicians can reduce antibiotic prescribing in high-income countries but the sustainability of reductions in antibiotic prescribing is unclear.

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Metrics

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References

Details

Published: Dec 19, 2016
Vol/Issue: 72(4)
Pages: 975-987
License: View

Authors

E

Elizabeth Louise Anne Cross

Public Health Team, Wiltshire Council, County Hall, Bythesea Road, Trowbridge, BA14 8JN, UK

R

Robert Tolfree

Public Health Team, Somerset Council, County Hall, Taunton, TA1 4DY, UK

R

Ruth Kipping

School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK

Funding

Wellcome Trust

British Heart Foundation

Medical Research Council

NIH

Cancer Research UK

Economic and Social Research Council

South West Public Health Training Programme

The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement

UK Clinical Research Collaboration Public Health Research Centre of Excellence Award: MR/KO232331/1

Cite This Article

Elizabeth Louise Anne Cross, Robert Tolfree, Ruth Kipping (2016). Systematic review of public-targeted communication interventions to improve antibiotic use. Journal of Antimicrobial Chemotherapy, 72(4), 975-987. https://doi.org/10.1093/jac/dkw520

Systematic review of public-targeted communication interventions to improve antibiotic use

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