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Research
How to improve antibiotic awareness campaigns: findings of a WHO global survey
  1. Benedikt Huttner1,2,
  2. Mirko Saam3,
  3. Lorenzo Moja2,
  4. Karen Mah4,
  5. Marc Sprenger4,
  6. Stephan Harbarth1,
  7. Nicola Magrini2
  1. 1Infection Control Program and Division of Infectious Diseases, World Health Organization Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
  2. 2World Health Organization, Department of Essential Medicines and Health Products, World Health Organization, Geneva, Switzerland
  3. 3Communications in Science, Geneva, Switzerland
  4. 4World Health Organization, Antimicrobial Resistance Secretariat, Geneva, Switzerland
  1. Correspondence to Dr Benedikt Huttner; huttner.benedikt{at}gmail.com

Abstract

Introduction We aimed to examine the characteristics of antibiotic awareness campaigns (AAC) conducted on a national or regional level since 2010.

Methods In October 2016, the WHO invited stakeholders involved in the planning or conduct of AACs to answer a web questionnaire. We solicited general information about the characteristics of the AAC, with a particular focus on key messages supporting optimal use of antibiotics.

Results Stakeholders in 93 countries were contacted and 55 countries responded. Overall, 60 AACs from 16 low/middle-income countries (LMIC) and 31 high-income countries were identified. Forty-five campaigns (75%) were conducted on a national level and most of them (47/60; 78%) were organised by public health authorities and publicly funded. There were no major differences between LMICs and high-income countries in the types of key messages. The scientifically questionable ‘Finish your prescription’ slogan was used by 31 AACs (52%). A One Health approach was mentioned in 13/60 AACs (22%). Most messages were universally applicable; adaptation to locally prevalent public misconceptions was not systematic. The evaluation of the impact of campaigns was still incomplete, as only 18 AACs (30%) assessed their impact on antibiotic use.

Conclusion For future AACs, it seems essential to base messages more rigorously on scientific evidence, context specificities and behavioural change theory. A new generation of messages that encourage first-choice use of narrow spectrum antibiotics is needed, reflecting international efforts to preserve broad spectrum antibiotic classes. Evaluation of the impact of AACs remains suboptimal.

  • anti-bacterial agents
  • health communication
  • health education
  • drug resistance
  • bacterial
  • global health
  • World Health Organization
  • drug resistance, bacterial
  • awareness

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjgh-2018-001239

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    Footnotes

    • Handling editor Seye Abimbola

    • Presented at Parts of this paper have previously been presented as a 2017 WHO EML application entitled: 'Evaluation of antibiotic awareness campaigns', available at http://www.who.int/selection_medicines/committees/expert/21/applications/s6_antibiotic_awareness_campaigns.pdf

    • Contributors Conceived the study and secured funding: SH, BH and NM. Developed and conducted the survey: MS and BH with input from NM, LM and SH. Analysed the survey data: MS and BH. Wrote a first draft of the manuscript: MS and BH. Critically reviewed the manuscript for content and style: all authors.

    • Funding This manuscript was funded by a grant from WHO. BH has been in part supported by the DRIVE-AB (Driving reinvestment in research and development and responsible antibiotic use) project funded by the Innovative Medicines Initiative Joint Undertaking (IMI) under grant agreement number 115618, resources of which are composed of financial contribution from the European Union's 7th Framework Programme and the European Federation of Pharmaceutical Industries and Associations (EFPIA) companies' in-kind contribution.

    • Disclaimer BH and NM affirm that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained.

    • Competing interests SH is a temporary member of the speakers’ bureau for Takeda and the scientific advisory boards of DNA Electronics, Sandoz and Bayer. He has received financial support for investigator-initiated research activities from Pfizer.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Data are available upon request.