CONTEXT: Overuse of antibiotics has contributed to microbial resistance, compromising the treatment of bacterial infections. Very high levels (>50%) of antibiotic resistance among invasive Streptococcus pneumoniae have been documented in Knox County, Tennessee. OBJECTIVE: To determine the effectiveness of a community-wide intervention aimed at reducing inappropriate antibiotic use among children. DESIGN, SETTING, AND PARTICIPANTS: The Knox County Health Department led a multifaceted year-long campaign (May 1997 through April 1998) aimed at decreasing unnecessary antibiotic use among children. Tennessee's 3 other major urban counties (Shelby, Hamilton, and Davidson) did not conduct similar campaigns and served as controls. Evaluation included white and black children (aged <15 years) enrolled in Tennessee's Medicaid Managed Care Program in the 4 study counties, representing 36% of the study counties' children (464 200 person-years observed). INTERVENTION: Educational efforts were directed toward health care practitioners (primarily via peer leader presentations) and to the parents of young children and the public (primarily via printed materials). MAIN OUTCOME MEASURE: The intervention-attributable effect on antibiotic use, defined as the excess percentage change in oral antibiotic prescription rates in Knox County between the 12-month preintervention and postintervention periods, relative to that of control counties. RESULTS: Antibiotic prescription rates declined 19% and 8% among Knox County and control county children, respectively, yielding an 11% intervention-attributable decline (95% confidence interval, 8%-14%; P<.001). The intervention-attributable decrease in prescription rates was greatest among children aged 1 to less than 5 years (among white children, 8% [P<.001]; among black children, 18% [P<.001]). CONCLUSIONS: A community-wide educational intervention reduced antibiotic prescription levels among children in Knox County.
CONTEXT: Overuse of antibiotics has contributed to microbial resistance, compromising the treatment of bacterial infections. Very high levels (>50%) of antibiotic resistance among invasive Streptococcus pneumoniae have been documented in Knox County, Tennessee. OBJECTIVE: To determine the effectiveness of a community-wide intervention aimed at reducing inappropriate antibiotic use among children. DESIGN, SETTING, AND PARTICIPANTS: The Knox County Health Department led a multifaceted year-long campaign (May 1997 through April 1998) aimed at decreasing unnecessary antibiotic use among children. Tennessee's 3 other major urban counties (Shelby, Hamilton, and Davidson) did not conduct similar campaigns and served as controls. Evaluation included white and black children (aged <15 years) enrolled in Tennessee's Medicaid Managed Care Program in the 4 study counties, representing 36% of the study counties' children (464 200 person-years observed). INTERVENTION: Educational efforts were directed toward health care practitioners (primarily via peer leader presentations) and to the parents of young children and the public (primarily via printed materials). MAIN OUTCOME MEASURE: The intervention-attributable effect on antibiotic use, defined as the excess percentage change in oral antibiotic prescription rates in Knox County between the 12-month preintervention and postintervention periods, relative to that of control counties. RESULTS: Antibiotic prescription rates declined 19% and 8% among Knox County and control county children, respectively, yielding an 11% intervention-attributable decline (95% confidence interval, 8%-14%; P<.001). The intervention-attributable decrease in prescription rates was greatest among children aged 1 to less than 5 years (among white children, 8% [P<.001]; among black children, 18% [P<.001]). CONCLUSIONS: A community-wide educational intervention reduced antibiotic prescription levels among children in Knox County.
Authors: Alike W van der Velden; Eefje J Pijpers; Marijke M Kuyvenhoven; Sarah K G Tonkin-Crine; Paul Little; Theo J M Verheij Journal: Br J Gen Pract Date: 2012-12 Impact factor: 5.386
Authors: C Franchi; M Sequi; M Bonati; A Nobili; L Pasina; A Bortolotti; I Fortino; L Merlino; A Clavenna Journal: Infection Date: 2011-06-25 Impact factor: 3.553
Authors: Ralph Gonzales; Kitty K Corbett; Bonnie A Leeman-Castillo; Judith Glazner; Kathleen Erbacher; Carol A Darr; Shale Wong; Judith H Maselli; Angela Sauaia; Karen Kafadar Journal: Health Serv Res Date: 2005-02 Impact factor: 3.402
Authors: Jonathan C Craig; Gabrielle J Williams; Mike Jones; Miriam Codarini; Petra Macaskill; Andrew Hayen; Les Irwig; Dominic A Fitzgerald; David Isaacs; Mary McCaskill Journal: BMJ Date: 2010-04-20
Authors: Anita L Kozyrskyj; Anita G Carrie; Garey B Mazowita; Lisa M Lix; Terry P Klassen; Barbara J Law Journal: CMAJ Date: 2004-07-20 Impact factor: 8.262