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November 24, 2004

Association Between Antibiotic Sales and Public Campaigns for Their Appropriate Use

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(20):2465-2470. doi:10.1001/jama.292.20.2468-b

To the Editor: Two public campaigns for more rational use of antibiotics were organized in Belgium in 2000-2001 and 2001-2002 with a goal of reducing overuse and misuse of antibiotics in the community. We assessed their effectiveness with a time-series analysis that examined changes in antibiotic sales, accounting for the confounding effect of the seasonal variation of influenza-like illnesses (ILIs).


Each 3-month campaign concentrated on simple messages, together with a series of specific answers on topics of interest, that were conveyed through booklets, handouts, posters, prime-time television spots, and Web sites.1 Examples included “Use antibiotics less frequently but better”; “Save antibiotics, they may save your life”; and “Talk to your Doctor, Talk to your Pharmacist.” Monthly outpatient antibiotic use in the community was estimated for the 1996-2002 period by extrapolation from sales data that covered 80.1% of all community pharmacies and 76.1% of the population. Sales data were converted to defined daily doses (DDDs).2 This unit is the assumed average maintenance dose per day for a drug used in adults for its main indication as defined by the World Health Organization; it allows for direct comparisons of drug use over time and place. National yearly gross antibiotic sales data were obtained from Intercontinental Marketing Services (IMS-Health) over the 1996-2002 period. In Belgium, antibiotics are available by prescription only.

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