Objectives:

• To increase understanding of the appropriate use of antibiotics.
• To raise awareness that inappropriate use of antibiotics reduces their effectiveness.
• To support GPs by discouraging inappropriate patient demand for antibiotics.
• To encourage members of the public to wash their hands more regularly.
• To raise awareness of how easily germs are spread.
  

Background:
Antimicrobial agents (antibiotics) have been used successfully over the last 50 years to treat and prevent infection in man and animals. Over this time their usage has increased steadily. Bacteria, which could resist and survive antimicrobial therapy, appeared soon after these drugs were introduced and in recent years have become increasingly common. Antimicrobial resistance leads to failure of treatment and longer and more serious illnesses. There is a risk that in future we may not be able to treat infections effectively (Ref 1). Antibiotic resistance is now recognised as a global health crisis with enormous economic implications. Over prescribing and inappropriate use of antibiotics, especially for viral respiratory tract infections are major contributors to the development of antibiotic resistance.

In response to this the Department of Health, Social Services and Public Safety devised an Antimicrobial Resistance Action Plan (AMRAP). This action plan aims to combat the continuing overuse of antibiotics which has led to them becoming less effective at fighting infections. Antibiotics can be life-saving in serious infections caused by bacteria, such as kidney infections, pneumonia, meningitis and blood poisoning. They do not fight viral infections such as the symptoms of common coughs, colds or flu, despite many people using them for this purpose. Neither are they beneficial in most cases of sore throat, sore ear or sinusitis. In addition AMRAP covers the action that can be taken to control the spread of infection, such as regular hand washing.

As part of AMRAP the DHSSPS commissioned the HPA to develop and implement a public information campaign to discourage inappropriate demand for antibiotics and encourage regular hand washing to prevent the spread of infection.

In addition, research commissioned by the HPA in 2003 found that more than three quarters of GPs (78%) felt the single most helpful thing that would support them in reducing the level of antibiotic prescribing was a public information campaign to discourage patient demand.

The campaign:
The campaign incorporates two television advertisements which are supported by posters and information leaflets. Qualitative research in the form of focus groups was carried out during the development of the campaign to pre-test creative concepts and messages for the advertising and literature.

The campaign took a two pronged approach, promoting two complementary key messages, Protect antibiotics so they can protect you. Against colds and flu there’s nothing antibiotics can do and Help prevent infection – wash your hands regularly. The two messages were communicated through separate television advertisements and print materials.

The campaign was first launched in March 2004. Then in December 2004 the ‘Protect antibiotics so they can protect you’ element of the campaign was rerun to coincide with the increase in demand for antibiotics which arises with the onset of winter colds, flu and sore throats. This was followed by a rerun of the supporting campaign ‘Help prevent infection – wash your hands regularly’ in January 2005.

Television advertising

• Protect antibiotics so they can protect you.

This animated advertisement uses straightforward language to explain that antibiotics are not an effective treatment for colds, flu and most sore throats and coughs. The ad also demonstrates that antibiotics are a powerful drug but inappropriate use of antibiotics makes them weaker.

Click here to view the 'antibiotics' television advert

This ad features the strapline:
‘Protect antibiotics so they can protect you. Against colds and flu there’s nothing antibiotics can do.’

• Help prevent infection – wash your hands regularly.

This advertisement demonstrates just how easily germs that cause infection can be spread. The ad encourages us to consider all the things we touch that would have been touched by other people (including those who do not wash their hands) and are carrying germs. The ad carries a simple strapline:
Help prevent infection – wash your hands regularly.

Click here to view the 'handwashing' television advert

Print materials

Print materials were produced to support the advertising.

• Protect antibiotics so they can protect you.

The poster and leaflet for this element of the campaign were distributed to GPs and pharmacies.

• Help prevent infection – wash your hands regularly.

The poster and leaflet for this element of the campaign were distributed to GPs, pharmacies and opticians. The leaflet was also made available to the public as an insert in a local evening newspaper. In addition stickers for display near hand washing facilities were produced and distributed to all infection control teams in Health and Social Services Trusts in Northern Ireland. The stickers were also made available to local Councils to distribute to appropriate outlets in their areas.

Organisations and members of the public can obtain copies of all print materials for this campaign by contacting the Central Health Promotion Resource Service at their local Health and Social Services Board.