Paul M Tulkens
Université catholique de Louvain, Belgium
Title: Are public campaigns effective to reduce antibiotic overconsumption: Did we fail to provide what is needed by the general practitioner?
Biography
Biography: Paul M Tulkens
Abstract
Overconsumption of antibiotics is a major cause of increased bacterial resistance especially in the community. In the late 1990's, it became evident that the sales of prescribed antibiotics in the community in Belgium far exceeded that of other EU countries, largely due to patients' pressures. Accordingly, a public campaign was launched in 2000 (key message: "Do not ask for an antibiotic for non-bacterial infections") and repeated each year until now. The first campaigns (2000-2001 and 2001-2002) caused a significant reduction in antibiotic use (expressed in daily Defined Daily Doses [DDD] per inhabitant and per year). However, no further decrease but an increase was seen all over the 2003 to 2013 period. In parallel, focus groups studies with general practitioners, in-depth analysis of prescriptions habits through interviews with prescribers and national questionnaire studies showed that the main reasons for overprescribing antibiotics were the lack of early and unambiguous causal diagnostic (viral vs. bacterial infection), the pressure of patients when in need of a fast relief and the prescriber's fear of complications if not prescribing an antibiotic coverage. We conclude that public campaigns for reducing antibiotic over prescription in the community are not effective in reducing antibiotic consumption because they do not address the real causes of the prescriber's deviation from the proposed guidelines. Efforts should be directed towards definite improvements in early diagnostic and in the setting up of effective prevention measures about potential complications of infections for which no antibiotic would have been prescribed as per the guidelines.