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

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)975-987
Number of pages13
JournalJournal of Antimicrobial Chemotherapy
Issue number4
Early online date19 Dec 2016
DateAccepted/In press - 7 Nov 2016
DateE-pub ahead of print - 19 Dec 2016
DatePublished (current) - Apr 2017


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.

    Research areas

  • Antibiotic prescribing, Public health, Communication, Systematic Review

    Structured keywords

  • DECIPHer

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    Rights statement: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Oxford University Press at Please refer to any applicable terms of use of the publisher.

    Accepted author manuscript, 651 KB, PDF document


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