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5 6 7 Antibiotics are often unnecessarily and inappropriately


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pandora bracelets Depending on specific topics pandora necklaces, involvement of health professionals may be particularly relevant too. Appropriate use of antibiotics has been frequently addressed by health information campaigns, especially in high income countries,3 as is also recommended by the European Commission.4 The excessive use of antibiotics is associated with antimicrobial resistance, a worldwide problem and an increasing threat to global health.5 6 7 Antibiotics are often unnecessarily and inappropriately prescribed, especially for upper respiratory tract infections and for urinary tract infections in women.3 The objective of campaigns is to raise public awareness of this problem and to affect doctors‘ prescribing behaviours, while considering the influence citizens may exert on their doctors either directly (when patients request the filling of a prescription)8 or indirectly (when doctors think their patients expect a prescription).9 10In Europe, threefold differences in antibiotic prescribing exist between countries with the highest use of antibiotics compared with the lowest use (generally southern versus northern European countries, respectively).11 Cultural factors seem important for explaining these differences,12 and organisational factors related to health services may also play a role.13 Up to threefold variations in antibiotic prescribing also exist among southern and northern regions in Italy,14 where antibiotic use (as well as resistance of different bacteria to antibiotics15) is among the highest in Europe, although a 5.3% decrease was observed in 2010 compared with the preceding year to coincide with two national information campaigns carried out during the winter seasons of 2009 and 2010,16 with national media coverage but without direct involvement of health professionals. The campaigns mainly used posters/billboards in streets, public spaces, and health service facilities, and on public transport, and public service announcements on national television.Systematic reviews show that campaigns can be moderately effective in limiting the excessive use of antibiotics,3 17 18 19 especially when local context and barriers are adequately analysed and addressed,17 although limits in study design (for example, lack of a control group) often make their evaluation difficult pandora bracelets.

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