Initiative reduces unneeded antibiotics slightly

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Prescribing antibiotics when they're not really needed, and not taking them properly, has been blamed for the emergence of microbes that are resistant to antibiotics. Dr. Jonathan A. Finkelstein at Harvard Medical School and colleagues conducted a program in 16 Massachusetts communities between 1988 and 2003 to reduce the unnecessary dispensing of antibiotics.

NEW YORK (Reuters Health) - An effort to change doctors' prescribing habits for antibiotics and to educate parents of small children about the proper use of antibiotics was only moderately successful at curbing antibiotic use, Boston researchers report.

Prescribing antibiotics when they're not really needed, and not taking them properly, has been blamed for the emergence of microbes that are resistant to antibiotics. Dr. Jonathan A. Finkelstein at Harvard Medical School and colleagues conducted a program in 16 Massachusetts communities between 1988 and 2003 to reduce the unnecessary dispensing of antibiotics.

As described in the journal Pediatrics, strategies implemented among doctors included guideline education, small-group education with frequent updates and feedback about their prescribing patterns. Parents also received educational materials by mail, in doctors' offices, at pharmacies and in childcare settings.

Finkelstein's team measured changes in antibiotic prescribing rates among three groups of children: 3 to 24 months, 24 to 48 months, and 48 to 72 months.

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By the end of the study, the intervention had not changed the rate of antibiotic use in the youngest group, but for children between 24 and 48 months, the rates decreased by 4.2 percent and for the oldest children, the rates decreased by 6.7 percent.

While this was going on, there was also a substantial decline in antibiotic prescribing generally, however.

"A sustained, multifaceted, community-level intervention was only modestly successful at decreasing overall antibiotic use beyond substantial secular trends," Finkelstein's group concludes.

SOURCE: Pediatrics, January 2008.