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Educational antibiotic advertising
Abstract:
Antibiotic audits that were conducted within our hospital between 1978 and 1982 showed persisting patterns of inappropriate antibiotic use. A commercial advertising agency was commissioned to plan a campaign to change entrenched prescribing habits. Amoxycillin was chosen as the test drug because previous audits consistently had shown that its intravenous administration was prescribed more frequently than was that of benzylpenicillin in the treatment of primary pneumonia. In addition, amoxycillin given by mouth was prescribed six-hourly rather than eight-hourly in one-third of the patients who were surveyed. A three-month remedial campaign used direct mail (pads and pens), display stands and posters, all of which focused on the booklet Antibiotic guidelines. Educational material was placed wherever staff members congregated. At the end of the campaign, intravenously administered amoxycillin was used in only 8% of 50 patients with primary pneumonia and amoxycillin given by mouth was prescribed six-hourly in only 10% of 99 patients. These changed habits were sustained six months after the campaign but showed some fall-off 18 months after the campaign. The campaign costs of $10,000 were recouped within 12 months by savings on drug costs. It is concluded that educational advertising is an effective means of changing prescribing behaviour in a hospital.
Insights
Educational advertising effectively changed prescribing habits for antibiotics like amoxycillin in hospitals. This campaign improved appropriate drug use and administration frequency, demonstrating a sustainable impact on antibiotic stewardship.
Area of Science:
- Hospital Pharmacy
- Antibiotic Stewardship
- Health Behavior Change
Background:
- Persistent inappropriate antibiotic use identified through audits between 1978-1982.
- Specific issues included frequent intravenous amoxycillin over benzylpenicillin for pneumonia and incorrect oral amoxycillin dosing intervals.
Purpose of the Study:
- To evaluate the effectiveness of an educational advertising campaign in modifying entrenched antibiotic prescribing habits.
- To assess the impact on the use of amoxycillin, a commonly misused antibiotic.
Main Methods:
- A three-month educational campaign utilizing direct mail, display stands, and posters.
- Materials focused on promoting adherence to 'Antibiotic guidelines' booklet.
- Interventions were placed in staff congregation areas.
Main Results:
- Significant reduction in intravenous amoxycillin use for primary pneumonia (8% of patients).
- Marked decrease in six-hourly oral amoxycillin prescribing (10% of patients).
- Positive prescribing changes were sustained for at least six months post-campaign.
Conclusions:
- Educational advertising is a viable strategy for improving hospital antibiotic prescribing behavior.
- The campaign demonstrated cost-effectiveness, with savings on drug costs recouping initial investment.
- Sustained behavioral change is achievable, though long-term adherence requires monitoring.