Presented by: Alexa DiGaetano, Russel Turco, Erica Bliszcz, Chelsey Kiefer, Alyssa Bartels, Kara Nesbitt

Antibiotics and Children: Where do we draw the line?

Antibiotics: one of the scientific breakthroughs of the 20th century

Early 1900’s: no medicines against common germs

Before antibiotics, 90% of children with bacterial meningitis died

Strep throat considered a fatal disease

Other serious infections caused by aggressive bacteria reproduced with extraordinary speed and led to serious illness/death

Background

First antibiotic: Penicillin

From nearly the start, doctors noticed Penicillin was not useful against certain strains of Staphylococcus aureus (bacteria that causes skin infections).

As of 2009, most popular for kids: Amoxicillin

Background

Children take too many antibiotics due to doctors overprescribing them, even when antibiotics may not cure the illness.

Parents do not know the difference between viruses and bacterial infections.

Antibiotic resistance continues to increase.

Issues

Pharmacy Database Audit200,000 prescriptions

Results40,000 or 20% of prescriptions given to

children with viral illness

Primary Research

Experiment1,556 Parents: Group A (control) 886 parents

Group B (experimental) 886 parents

Experiment Results Group A: No parents asked about antibiotics Group B: 81% of parents asked doctors about

reasoning for antibiotics and other organic remedies.

Primary Research

Survey of American pediatricians:40%- parents requested antibiotics30%- physicians complied knowing they weren’t

neededOveruse of antibiotics links to antimicrobial

resistance21%- pediatric ambulatory visits result in antibiotic

prescription70%- antibiotic prescribed was unnecessary23%- unnecessary antibiotic prescriptions for

respiratory visitsConcerns of “superbugs” emerging

Secondary Research

Studies show parents provided with information prior to children becoming ill resulted in a 16% decrease of consultations for sore throat13% for cough40% consultation decrease per person/year

Interventions prove more effective when given to parents and children

Written information with focused content remains more effective than generic messages

Secondary Research

Report Audit by Pediatrics

1993-200824% drop in antibiotics for respiratory infections19% drop in antibiotics for coldsOverall, 58% children prescribed antibiotics

actually had a respiratory infection2011

Greater than 50% of all prescriptions written for children 14 and under deemed unnecessary

Parents of infants demand antibiotics-difficult for doctors to refuse

Secondary Research

External

•Doctors •Health Professionals -Nurse practitioners, physician’s assistants

•Parents•Caretakers

Intermediary

•Doctors •Health Professionals -Nurse practitioners, physician’s assistants

•Lifestyle and Nutrition sections in various health media

Internal

•Doctors•Board Members

Special

•Drug Makers/Drug Reps•Government Agencies (FDA, ACF, CDC)•Lifestyle and Nutrition sections in various health media

Audiences

Must Influence (Priority Target)

Should Influence (Secondary Target)

•Doctors•Parents

•Caretakers•Board Members

•Lifestyle and Nutrition sections in various health

media•Government Agencies

(FDA, ACF, CDC)

•Drug Reps/Companies

Maximum PR Effort Significant PR Effort

Audience Ranking Chart

Likely to Influence

Unlikely to Influence

MAC TriadMessage Audience Channel

Write fewer antibiotic prescriptions and help end the problem of children becoming antibiotic-resistant.

Doctors, Health Professionals

trade shows, pamphlets,

luncheons, e-mail campaign, webinars

Learn the difference between viruses and bacterial infections to help end the problem of children becoming antibiotic-resistant.

Parents, Caregivers, Government Agencies

pamphlets, webinars, radio broadcasts

Parents and doctors need to reduce the amount of antibiotics taken by children to help end the problem of children becoming antibiotic-resistant.

Health Media news releases

Encourage doctors to use drugs only when necessary and become respected ethically.

Drug Reps news releases, luncheons, events

Objective 1.0 Reduce the number of antibiotics prescribed to children in the U.S. by 10% in one year.

Strategy 1.1 Refresh doctor knowledge on differences between viruses and bacterial infections to reduce the number of prescriptions written.

Tactic 1.1.1 Trade show with speakerTactic 1.2.1 NewslettersTactic 1.3.1 Direct Mail

-Letter describing health concern -Insert

Issue: Children take too many antibiotics due to doctors overprescribing them, even when antibiotics may not cure the illness.

Objective 2.0 Increase parents’ understanding of viruses versus bacterial infections by 25% within three months.

Strategy 2.1 Provide parents with educational material to reduce the number of doctor visits that lead to prescriptions for antibiotics.

Tactic 2.1.1 Create and launch an informational web campaign.

Tactic 2.1.2 Medical brochure explaining differences between viruses and bacterial infections

Tactic 2.1.3 Question and answer sessions with medical expert

Issue: Parents do not know the difference between viruses and bacterial infections.

Objective 3.0 Increase media awareness by publishing articles in one out of ten outlets that receive information.

Strategy 3.1 Highlight health risks of children taking too many antibiotics to increase interest of parents.

Tactic 3.1.1 Editor lunch-ins Tactic 3.1.2 News releases Tactic 3.1.3 Commercials

Issue: Antibiotic resistance continues to increase.

Budget Activity Estimated Cost

Website Launch $8,000

Pamphlets $5,000

Research $100,000

Radio Broadcast $20,000

Trade Shows (10) $100,000

Speakers (webinars, tradeshows)

$300,000

E-mail Campaigns $500

Luncheons $50,000

FINAL COST: $583,500

EvaluationObjective 1.0 Reduce the number of

antibiotics prescribed to children in the U.S. by 10% in one year. – MET

Refreshed doctors’ knowledgeIncreased attendance

20% of doctors attended

EvaluationObjective 2.0 Increase parents’ understanding of

viruses versus bacterial infections by 25% within three months. – MET

Provide parents with educational informationWeb campaign

Successful; reached a total of 50% of our target audienceBrochure with difference between viral and

bacterial infections60% of parents questioned the need for antibiotics

Q&A sessionHealth professionals answered all questions parents had

EvaluationObjective 3.0 Increase media awareness by

publishing articles in one out of ten outlets that receive information. – MET

Highlight antibiotic resistance in children.Editor luncheons

Total of 50 editors attendedNews release

Pitched to 50 different publications, 35 picked it upRadio broadcast

Potter Model

LoyaltiesYes – Increase revenue – keeping

the company in existence.No – Over-prescribing

antibiotics to children is wrong.

PrinciplesYes – Aristotle’s Golden Mean: “Greatest good for the greatest

number.”Mill’s Principle of Utility: “What is

useful is right”No - Rawl’s Veil of Ignorance:

“Eliminate roles to justly decide.”

ValuesYes – Antibiotics decrease

sickness and make people feel they received accurate

treatment.No – Honesty and integrity are

more important than comforting parents with antibiotics.

DefinitionYes – Antibiotics help children

get better and decrease parental concern.

No – Children should not be take an abundant number of

antibiotics due to health risks.

Is it ethical to over-prescribe antibiotics to children to please parents?