Antibiotic consumption successfully reduced by a community intervention program

Background: The association between antibiotic use in the community and antimicrobial resistance is known. Attention has recently focused on the type of agents being prescribed. Objectives: To implement, evaluate and compare the efficacy of two community intervention programs - continuous versus seasonal medical education - oriented to primary care physicians With emphasis on the appropriate use of antimicrobial drugs. Methods: From October 2000 to April 2003 we conducted two interventions: a) a monthly educational campaign in selected clinics promoting appropriate diagnosis of common infectious diseases and prudent antibiotic use (continuous intervention group); and b): a massive educational campaign, conducted before two consecutive winters, promoting the judicious: use olf antibiotics for treating respiratory infections (continuos intervention group and seasonal intervention group). Sixteen similar clinics were randomized (8 to each, group). The total antibiotic use was measured as defined daily dose/1000 patients/ day, and compared between the groups. Results: The total use of antibiotics decraased between 1999-2000 and 2002-2003 in both groups, but slightly more significantly in the continuous intervention group. This DDD/1000 patients/day for seasonal group in 1999-2000 was 27.8 vs. 23.2 In 2002-2003; and for the continuous gnoup 28.7 in 1999-2000 vs. 22.9 in 2002-2003, a reduction of 16.5% and 20.0% respectively (P < 0.0001). The main charge in antibiotic use was noted for broad-spectrum antibiotics. Conclusion: We present a successful community intervention program-aimed to reduce unnecessary antibiotic use. Amplification of this type of intervention is imperative to stop the increase in antimicrobial resistance.