title: Impact of statewide program to promote appropriate antimicrobial drug use.
abstract: The Wisconsin Antibiotic Resistance Network (WARN) was launched in 1999 to educate physicians and the public about judicious antimicrobial drug use. Public education included radio and television advertisements, posters, pamphlets, and presentations at childcare centers. Physician education included mailings, susceptibility reports, practice guidelines, satellite conferences, and presentations. We analyzed antimicrobial prescribing data for primary care physicians in Wisconsin and Minnesota (control state). Antimicrobial prescribing declined 19.8% in Minnesota and 20.4% in Wisconsin from 1998 to 2003. Prescribing by internists declined significantly more in Wisconsin than Minnesota, but the opposite was true for pediatricians. We conclude that the secular trend of declining antimicrobial drug use continued through 2003, but a large-scale educational program did not generate greater reductions in Wisconsin despite improved knowledge. State and local organizations should consider a balanced approach that includes limited statewide educational activities with increasing emphasis on local, provider-level interventions and policy development to promote careful antimicrobial drug use.
authors.affiliation: Marshfield Clinic Research Foundation, Marshfield, Wisconsin 54449, USA. belongia.edward@marshfieldclinic.org
authors.forename: Edward A
authors.initials: EA
authors.lastname: Belongia
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Knobloch
authors.forename: Burney A
authors.initials: BA
authors.lastname: Kieke
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Davis
authors.forename: Carolyn
authors.initials: C
authors.lastname: Janette
authors.forename: Richard E
authors.initials: RE
authors.lastname: Besser
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use*; D003146:Communications Media; D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization; D004502:Education, Medical, Continuing; D006078:Government Programs; D006266:Health Education; D006801:Humans; D010821:Physicians, Family / Q000193:education*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015397:Program Evaluation; D014922:Wisconsin
chemical_list: D000900:Anti-Bacterial Agents