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Cited by 118Antibiotic Use and ResistanceHealthcare cost, quality, practicesSurgical site infection prevention

Systematic review of public-targeted communication interventions to improve antibiotic use

Open access
Cross, Elizabeth Louise Anne, Tolfree, Robert, Kipping, Ruth·2017·Journal of Antimicrobial Chemotherapy
DOI 10.1093/jac/dkw520PMC PMC7263825
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Abstract

Background: Excessive use of antibiotics accelerates the acquisition/spread of antimicrobial resistance. A systematic review was conducted to identify the components of successful communication interventions targeted at the general public to improve antibiotic use. Methods: The databases MEDLINE, EMBASE, CINAHL, Web of Science and Cochrane Library were searched. Search terms were related to the population (public, community), intervention (campaign, mass media) and outcomes (antibiotic, antimicrobial resistance). References were screened for inclusion by one author with a random subset of 10% screened by a second author. No date restrictions were applied and only articles in the English language were considered. Studies had to have a control group or be an interrupted time-series. Outcomes had to measure change in antibiotic-related prescribing/consumption and/or the public’s knowledge, attitudes or behaviour. Two reviewers assessed the quality of studies. Narrative synthesis was performed. Results: Fourteen studies were included with an estimated 74–75 million participants. Most studies were conducted in the United States or Europe and targeted both the general public and clinicians. Twelve of the studies measured changes in antibiotic prescribing. There was quite strong (P < 0·05 to ≥ 0·01) to very strong (P < 0·001) evidence that interventions that targeted prescribing for RTIs were associated with decreases in antibiotic prescribing; the majority of these studies reported reductions of greater than −14% with the largest effect size reaching −30%. Conclusion: Multi-faceted communication interventions that target both the general public and clinicians can reduce antibiotic prescribing in high-income countries but the sustainability of reductions in antibiotic prescribing is unclear.

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  • This result appears consistent with findings from other systematic reviews both within and outside SSA, as none of the reviews reported AMR interventions specifically tailored to accommodate persons living with disabilities.

    “This result appears consistent with findings from other systematic reviews both within and outside SSA, as none of the reviews reported AMR interventions specifically tailored to accommodate persons living with disabilities.11 13 16 20 21”

    From Public-targeted interventions addressing antimicrobial resistance and antibiotic use in Sub-Saharan Africa: a scoping review (2025) · cites this paper as [16]

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Authors
Cross, E. L. A., Tolfree, R., & Kipping, R.
Affiliations
  • Wiltshire Council (GB)
  • Somerset County Council (GB)
  • University of Bristol (GB)
Corresponding author
Cross, Elizabeth Louise Anne
ORCID
Venue
Journal of Antimicrobial Chemotherapy
Publisher
Oxford University Press (OUP)
Published
2016-12-19
Volume
72
Issue
4
Pages
975-987
ISSN
  • 0305-7453 (ISSN-L)
  • 1460-2091
DOI
10.1093/jac/dkw520
PMC
PMC7263825
OpenAlex
W2561333628
Cited by
118
References
3
Citations by year
2026: 6 · 2025: 13 · 2024: 16 · 2023: 11 · 2022: 16 · 2021: 14 · 2020: 20 · 2019: 12 · 2018: 5 · 2017: 5
FWCI
0.75
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Antimicrobial Chemotherapy (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Bristol Research (University of Bristol) (submittedVersion, other-oa)
  • Explore Bristol Research (submittedVersion, other-oa)
Funders
  • NIH
  • South West Public Health Training Programme
  • The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement
  • UK Clinical Research Collaboration Public Health Research Centre of Excellence (MR/KO232331/1)
  • British Heart Foundation
  • Cancer Research UK
  • Economic and Social Research Council
  • Medical Research Council
  • Welsh Government
  • Wellcome Trust
Topics
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
  • Health Sciences › Medicine › Surgery › Surgical site infection prevention
Keywords
antibiotic prescribing, antimicrobial resistance, public health communication, health communication interventions, mass media campaigns, respiratory infections, antibiotic overuse, public knowledge and attitudes
MeSH terms
Anti-Bacterial Agents, Behavior Therapy, Drug Utilization, Health Education, Humans, Global Health, Drug Resistance, Bacterial, Health Communication

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