Developing a patient intervention to reduce antibiotic overuse

The emergence of drug resistance among common community-acquired bacterial infections has been clearly linked to the overuse of antibiotics. To address this problem, guidelines have been developed for the judicious use of antibiotics, particularly with regard to respiratory infection in adults and children. In addition, the CDC has promulgated guidelines for the general public, exhorting patients not to take an antibiotic for viral illnesses, not to pressure practitioners for antibiotic therapy, not to use antibiotics prescribed for another person, and not to use antibiotics left over from a previous illness. Despite some overall decline in antibiotic use, patients continue to engage in antibiotic overuse practices, resulting in increasing antimicrobial resistance. One reasons for antibiotic overuse is "antibiotic expectation," in which patients expect to be treated with an antibiotic for an acute infection, whether it is viral or bacterial.1 This phenomenon points to an underlying system of beliefs held by patients toward antibiotic use that may be alterable by educational interventions.