Antibiotic resistance: the Iowa experience.
BACKGROUND
In the past 10 years, the number of strains of Streptococcus pneumoniae and other common respiratory pathogens that are resistant to penicillin has increased.


OBJECTIVE
The Iowa Department of Public Health convened a multidisciplinary task force in January 1998 to develop strategies to combat antibiotic resistance in the state because they were alarmed by these reports.


METHODS
Within 18 months, the task force implemented statewide surveillance of resistant organisms and posted information about the surveillance on the Internet, distributed a public health guide on judicious antibiotic use and infection control measures to 7500 healthcare providers, and held a press conference to inform the public about antibiotic resistance. The task force collaborated with several major insurers in the state to profile the top prescribers of antibiotic agents in their plan.


CONCLUSIONS
The profiling and educational interventions led to a substantial decrease in both overall antibiotic prescribing and drug costs. Other states may want to undertake similar programs to help protect their citizens from infections caused by resistant pathogens.
Bell
Nancy
N
Iowa Pharmacy Association, Des Moines, 50322, USA. nbell@iarx.org
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D004351:Drug Resistance; D004363:Drug Utilization / Q000592:standards*; D004502:Education, Medical, Continuing; D016983:Enterococcus / Q000302:isolation & purification; D006300:Health Services Misuse; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D011008:Pneumococcal Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D015980:Public Health Practice / Q000592:standards*; D018571:Sentinel Surveillance; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D013297:Streptococcus pyogenes / Q000302:isolation & purification; D013664:Teaching Materials
D000900:Anti-Bacterial Agents