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Table 2 Quasi Experimental Studies Demonstrating Decreased Antibiotic Prescription Rates in Response to Patient- or Public- Centered Educational Interventions Compared to Control

From: Communication interventions to promote the public’s awareness of antibiotics: a systematic review

Location of Intervention (years observed) Setting Patient Education Provider Education Outcome Measure Prescription Rate Change
Control (Full) Intervention Intervention Effect P value (intervention effect compared to control)
Denver-Boulder Colorado (1996–1998) [32] MCO practices Household mailings and office-based educational materials regarding self care, when to expect antibiotics, and harmful effects of antibiotics Education and meetings about management of acute bronchitis and how to say “no” to patients, site-specific prescribing rates Antibiotics for Adults with Acute Bronchitis −5% (P = 0.68) −26% (P = 0.003) Not reported 0.02
Denver, Colorado (2000–2001) [29] MCO Practices Household and office-based educational materials including CDC materials regarding resistance and facts about treatments for respiratory infections Prescribing profiles and practice guidelines Antibiotics for Adults with Acute Bronchitis − 10% (local control), − 6% (distant control) −24% Not reported 0.006 (local control)
< 0.002 (distant control)
Denver, Colorado (2002–2003) [30] Community-wide Media campaign with out-of-home advertising, office-based materials Physician advocacy activities were mailed: postcards soliciting support, office materials, stethoscope clips Antibiotic dispenses/1000 MCO members Values not noted −8.8% (P = 0.03) Not reported Not reported
Rural Alaska (1998–1999) [36] Rural Communities Villiage meetings, community fairs, high school classrooms, and news letters about respiratory infections and antibiotic resistance Workshops for community health aids and physicians to review principles of appropriate use Antibiotic Courses/person −9.5% (P < 0.05) −31% (P < 0.01) Not reported Not reported
Sacramento, California (1998–1999) [37] MCO (clinic, urgent care) Office-based materials and newsletter regarding indications for antibiotics, bacterial resistance, how to prevent infection, and how to take antibiotics Clinical pharmacists presented CDC Judicious Use principles to physicians, nurse practitioners, and physician assistants. Provider-specific antibiotic prescribing profiles and cold kits were included. Antibiotics for Acute Bronchitis 0% −20% (P = 0.001) Not reported Not reported
Knox County, Tennessee (1997–1998) [43] Community-wide Printed materials and public media regarding indications for antibiotics Lectures by a CDC physician and other presentations, prescribing guidelines, newsletters Children < 15 years old (antibiotics/person-year) −8% −19% − 11% (95%CI[− 8,-14%]) < 0.001
Utah (2001) [44] Rural Community Office-based informational brochures, media campaign about antibiotic resistance Small group sessions overviewing antibiotic resistance and appropriate antibiotic use, algorithms Upper respiratory tract infections treated with an antibiotic −1.5% (P = 0.047) − 15.6% (P = 0.002) Not reported 0.006
Price, Rusk, Lincoln Counties, Wisconsin (1997) [24] Community-wide CDC pamphlets and posters distributed to clinics, pharmacies, child care facilities, schools Grand rounds and small-group meetings regarding judicious use for pediatric respiratory infections, practice guidelines, CDC fact sheets Solid antibiotic prescriptions/clinician −8% (P = 0.934) − 19% (P < 0.001) − 11% 0.042
Liquid antibiotic prescriptions/clinician 12% (P = 0.064) −11% (P = 0.064) −23% 0.019