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The use of a poster to reduce expectations to receive antibiotics for a common cold

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European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Many doctors prescribe antibiotics for a cold, to meet patient’s expectations. As a result, patient’s education about antibiotics and antibiotic resistance forms a major component of the WHO’s Global Action Plan on Antimicrobial Resistance. However, it is not known whether simple educational material can change a person’s attitudes about antibiotic therapy. We designed three posters about antibiotic treatment for “cold and flu”. Hospital inpatients answered a baseline survey and then were asked to look at one of three randomly selected posters. The posters highlighted the futility of antibiotic treatment for colds (futility), the risk of adverse drug reactions from antibiotics (harm), and the issue of antimicrobial resistance (resistance). Participants then completed a follow-up survey. Participants’ expectations to receive antibiotics for a “bad cold” reduced significantly after viewing a poster (82/299, 27% expected antibiotics in the baseline survey compared with 13% in the follow-up survey, P < 0.01). Continuing expectation to receive antibiotics after viewing one of the posters was associated with expectation to receive antibiotics in the baseline survey and the strong belief that colds were caused by bacteria. Participants who viewed the resistance poster were more likely to continue to expect antibiotics than participants who viewed the futility poster (OR 2.46, 95%CI 1.16–5.20, P = 0.02). Following discussion of the study, viewing a poster reduced participants’ expectations to receive antibiotics for a hypothetical cold. Changing patients’ expectations to receive antibiotics using simple educational material about antibiotic futility could lead to significant reductions in antibiotic prescription for viral upper respiratory tract infections.

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Funding

The A+ Trust, Auckland District Health Board provided support in the form of a summer studentship (LR).

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Authors and Affiliations

  1. Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

    Stephen R. Ritchie, Lizzie Rakhmanova & Mark G. Thomas

  2. Auckland District Health Board, Auckland City Hospital, Auckland, New Zealand

    Stephen R. Ritchie, Stephen Reay & Mark G. Thomas

  3. School of Art and Design, AUT University, Auckland, New Zealand

    Eilish Out-O’Reilly & Stephen Reay

  4. Faculty of Business and Economics, University of Auckland, Auckland, New Zealand

    Laszlo Sajtos

Authors
  1. Stephen R. Ritchie
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  2. Lizzie Rakhmanova
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  3. Eilish Out-O’Reilly
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  4. Stephen Reay
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  5. Mark G. Thomas
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  6. Laszlo Sajtos
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Corresponding author

Correspondence to Stephen R. Ritchie.

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Ethical approval for this study (16/NTB/187) was provided by the Health and Disability Ethics Committee of the New Zealand Ministry of Health.

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Ritchie, S.R., Rakhmanova, L., Out-O’Reilly, E. et al. The use of a poster to reduce expectations to receive antibiotics for a common cold. Eur J Clin Microbiol Infect Dis 38, 1463–1469 (2019). https://doi.org/10.1007/s10096-019-03572-5

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  • DOI: https://doi.org/10.1007/s10096-019-03572-5

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