Objectives: Due to concerns about both costs and drug resistance, reducing antibiotic prescribing is a strategic aim for the UK National Health Service. A nationwide public education campaign launched in October 1999 (CATNAP) addressed this. The objectives were 1) to assess public attitudes to antibiotic use in a district with high antibiotic prescribing where a nationwide public education campaign was locally enhanced; 2) to assess the impact of the campaign on prescribing of antibiotics locally.
Design: 1) Questionnaire survey to test the hypothesis that public attitudes would be equivalent before and after local enhancement of the national campaign. 2) Prescribing data analysis to assess the impact of the campaign on prescribing of antibiotics.
Setting: London borough of Barking and Dagenham.
Outcome measures: 1) Differences in public attitudes to antibiotic prescribing pre and post the locally enhanced campaign. 2) Changes in prescribing rates pre and post the locally enhanced campaign.
Results: 1) Response rates in questionnaire study: 45% (442/982) initially, 42% (815/1941) at follow-up. Responses to all general questions were equivalent in both surveys. There was considerable misunderstanding amongst the population about the effectiveness of antibiotics, particularly in relation to viral infections, colds, sore throats and coughs. The proportion of responders who believed that children should be prescribed antibiotics for a fever was not equivalent in the two surveys, it decreased from 56% to 49%, the limit of the one-sided confidence interval was 13.5%. 2) The rate of change in prescriptions dispensed between 1998/9 and 1999/2000 was not significantly different from that expected, based on the previous years, in either England and Wales or Barking and Dagenham.
Conclusion: Using this study design and this method of locally enhancing a public education campaign, the locally enhanced campaign did not appear to influence the public's attitudes towards antibiotic prescribing in an area of high prescribing. Assessment of the attitudes of those who had definitely been exposed to the campaign and its messages to, and by, GPs might be more likely to produce a demonstrable change in attitudes.