Volume 11, Number 2—February 2005
Promoting Appropriate Antibiotic Use in the Community
The Get Smart: Know When Antibiotics Work 5th annual national conference was held June 3–4, 2004, in Atlanta, Georgia, USA. Get Smart: Know When Antibiotics Work is a health education campaign of the National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC). This campaign aims to reduce the spread of antibiotic resistance by promoting adherence to appropriate prescribing guidelines among providers, decreasing demand for antibiotics for viral upper respiratory infections among healthy adults and parents of young children, and increasing adherence to regimens for prescribed antibiotics for upper respiratory infections. The conference drew approximately 225 professionals who are dedicated to promoting appropriate antibiotic use, including representatives from state and local health departments, clinicians, pharmacists, professional organizations, managed care and health plans, public health organizations and agencies, and pharmaceutical companies.
The opening session provided an overview of CDC's "3 Programs, 1 Goal," a collaborative effort to prevent antimicrobial resistance in the United States. Richard Besser described the community campaign, Tom Chiller discussed the farm program, and Denise Cardo presented the healthcare settings campaign. The ensuing discussion focused on promoting appropriate use of antibiotics in agriculture, in which an estimated 25 million pounds of antimicrobial agents are used for nontherapeutic purposes (1). Karen Florini from Environmental Defense discussed this topic.
Ralph Gonzales, University of California, San Francisco, and Kitty Corbett, University of Colorado, Denver, presented results from their Colorado media campaign. According to an assessment using a preintervention-postintervention nonequivalent control design, >35,000 antibiotic prescriptions were avoided as a result of the campaign. Edward Belongia, Wisconsin Antibiotic Resistance Network Project, presented outcomes from their 5-year demonstration intervention project. Public and clinician knowledge and attitudes about antibiotic resistance and appropriate use improved in Wisconsin compared with results in the control state of Minnesota. Over the course of the intervention, secular trends toward reductions in antibiotic prescribing occurred in both states.
Carolyn Greene, CDC, moderated a panel discussion on promoting appropriate prescribing through provider training. The panel discussed an appropriate antibiotic use curriculum for fourth-year medical students; an appropriate antibiotic use curriculum for family practice, pediatric, and internal medicine residents; and a curriculum for pediatric and family practice residents to teach diagnosis of otitis media.
Ralph Gonzales presented information that confirmed that the rate of broad-spectrum antibiotic use was rising rapidly. Further studies need to be completed to determine whether this increased prescribing is necessary. As a result, the Get Smart: Know When Antibiotics Work campaign plans to promote the prescription of narrow-spectrum, targeted drugs when appropriate.
Barbara Mintzes, University of British Columbia, and Paul Rubin, Emory University, discussed the issue of advertising directly to consumers. Dr. Mintzes noted that drug advertising can result in unnecessary use, improper prescribing, and increased patient demand. Dr. Rubin noted that advertising medications allows consumers to be informed about their health options and that advertising can be economically beneficial to pharmaceutical companies, thereby contributing to their ability to invest in new drug development.
Breakout sessions included such topics as sustaining and evaluating appropriate antibiotic use programs and incorporating cultural competency. The sustainability session, presented by Michelle Johnston, Center for Civic Partnerships, introduced a process for determining how to best focus energy, time, and resources. Thomas Chapel, CDC, reviewed the steps of CDC's Evaluation Framework, led a discussion of the role of logic models in program planning and evaluation, and presented a case study with sample appropriate antibiotic use activities and outcomes. Suzanne Bronheim, National Center for Cultural Competence, discussed cultural competency, the ability of a person to understand and respect differences across cultures and to consider and respond appropriately to these differences in planning, implementing, and evaluating health education programs and interventions (2).
Mary Eley, Michigan Antibiotic Resistance Reduction Coalition, held a training session for her curriculum, "Antibiotics and You: Promoting Appropriate Antibiotic Use in Elementary Schools," a module designed to teach children the basics about bacteria and viruses and when antibiotics are necessary. Participants received toolkits, which would enable them to implement similar training sessions.
Conference participants reported that they increased their knowledge of appropriate antibiotic use programs, developed skills for program development and evaluation, acquired training in cultural competency, and found opportunities for collaboration. For more information, see http://www.cdc.gov/getsmart/.
- Union of Concerned Scientists. Food and environment: antibiotic resistance. [accessed 2004 Aug 3]. Available from http://www.ucsusa.org/food_and_environment/antibiotic_resistance/index.cfm
- American Association for Health Education. [accessed 2004 Sept 17]. Available from http://www.aahperd.org/aahe
Suggested citation for this article: Patti A, Weissman J. Promoting appropriate antibiotic use in the community [conference summary]. Emerg Infect Dis [serial on the Internet]. 2005 Feb [date cited]. http://dx.doi.org/10.3201/eid1102.041007