Public HealthPublic Health Campaign Associated With Major Reduction In Antibiotic Use
A national public health campaign in France was associated with a marked
reduction of unnecessary antibiotic prescriptions, particularly in
children,
says new research published in this week"s open-access journal PLoS
Medicine. The campaign, "Antibiotiques c"est pas automatique" (Antibiotics
are not automatic), ran from 2002 to 2007 during the winter months when
viral respiratory infections mainly occur. The campaign included an
educational campaign for healthcare workers, the promotion of rapid tests
for diagnosis of streptococcal infections, and a public information
campaign
about viral respiratory infections and about antibiotic resistance.
The researchers, led by Didier Guillemot at INSERM and Institut Pasteur in
Paris, France, report that compared to the preintervention period
(2000-2002), the total number of antibiotic prescriptions per 100
inhabitants, adjusted for frequency of flu-like symptoms during the winter
season,
declined by more than 25% over 5 years. The decline occurred in all 22
regions of France and affected all classes of antibiotic except
quinolones, say
the researchers. The greatest decrease was observed among young children
aged 6-15 years.
The authors note that because this is an ecological analysis, they cannot
conclude that the campaign actually caused the reduction in antibiotic
use.
Other factors that may have been responsible for the observed reduction
could include other initiatives in France and Belgium at the same time, or
the
introduction of a vaccine against Streptococcus pneumoniae during the
study period.
In a commentary on the article, Benedikt Huttner and Stephan Harbarth
(uninvolved in the research) say that this study "provides the largest and
most sophisticated analysis published thus far correlating a nationwide
public campaign to decreased antibiotic use over an extended period of
time." Because reducing antibiotic use to avoid antibiotic resistance is
so important, they argue, more longitudinal and modeling research to
evaluate the impact of public health strategies is needed.
Funding: No external funds were obtained for this work.
Citation:
"Significant Reduction of Antibiotic Use in the Community after a÷ Nationwide Campaign in France, 2002-2007."
Sabuncu E, David J, Berne`de-Bauduin C, Pe÷´pin S, Leroy M, et al. (2009)
PLoS Med 6(6): e1000084. doi:10.1371/journal.pmed.1000084
PLoS Medicine