Trends in antibiotic utilization associated with the "Do bugs need drugs?" program in British Columbia

The misuse and overuse of antibiotics in the treatment of respiratory tract infections contributes to the emergence of antibiotic resistance. “Do Bugs Need Drugs” (DBND) is a multi-faceted community education program which was implemented in British Columbia (BC) in September 2005 to increase appropriate antibiotic use and prevent the spread of infections and resistant organisms. The purpose of this study was to conduct a complete descriptive analysis on the association between DBND and changes in overall, pediatric, drug-specific and indication-specific antibiotic utilization trends in BC. Antibiotic utilization data on all oral solids classified as “antibacterials for systemic use” were obtained from the PharmaNet database for the years 1996 to 2007. These data were linked to the Medical Service Plan database. Following conversion to the defined daily dose, linear regression was used on the data to describe monthly utilization rates in each health service delivery area (HSDA) in BC. Finally, changes in antibiotic utilization trends were compared by level of program implementation to determine whether a pattern exists between differing level of public education and improvements in antibiotic use. The monthly rate of change of all antibiotic utilization rates targeted by the program improved in association with DBND implementation in the Vancouver HSDA. Within the other HSDAs, the monthly rate of change of targeted antibiotic utilization rates improved in all areas with high DBND implementation. Inconsistent results were recorded in areas with low to medium program implementation. Declines in fluoroquinolone and newer macrolide utilization rates were not observed. The findings of this study provide evidence that community education initiatives have the potential to improve antibiotic utilization trends in the long-term. They also demonstrate the importance of a high level of program implementation. However, as the utilization rates of commonly misused antibiotics continue to increase despite the program’s directed efforts, the results of this study suggest that education alone may not be enough to rapidly decrease current antibiotic utilization rates. Policy regulations may be required.Medicine, Faculty ofPopulation and Public Health (SPPH), School ofGraduat