A community program for wise use of antibiotics

The British Columbia Ministry of Health’s Pharmacare Division recently committed to 3 years of funding for implementing a community education program promoting the wise use of antibiotics. This funding provides British Columbia with an opportunity to improve stewardship of antibiotics with a view to slowing or arresting the emergence of resistant organisms.

The Do Bugs Need Drugs? Program (DBND) was originally developed by Capital Health (Edmonton), the Alberta Medical Association, the Alberta Lung Association, and the University of Alberta. The program started as a pilot project in Grande Prairie, Alberta in 1998–1999, then expanded to the Capital Health region in 2000. Currently the program is in use in Alberta, northern Saskatchewan, many Ontario health districts, and by First Nations and Inuit Health in Alberta.

British Columbia will use the DBND program to target health care professionals, public, and children with three key messages:

1. Wash your hands! Hand washing is the best way to stop the spread of infections.

2. Not all bugs are created equal. Antibiotics work against bacteria, but not against viruses.

3. Use antibiotics wisely! Bacteria can become resistant to antibiotics.

Health care professional education will begin this winter with an extensive mail-out to physicians, pharmacists, public health units, and health care students in medicine, pharmacy, and dentistry. The mail-out will include the 4th edition of the Bugs and Drugs handbook. This book provides recommendations for the management of patients with infectious diseases and has been reviewed by local infectious disease experts in British Columbia. It is produced independently of industry and many reviewers have concluded that its recommendations are more appropriate to primary care practice than many other sources. In addition to the book, health professionals will receive posters for patient waiting areas as well as pamphlets, parent guides, and stickers to distribute to their patients. Health care professionals are encouraged to re-order supplies from BCCDC, including print material in multiple languages.

Additionally, the BCCDC will be organizing a Main Pro C credit course for physicians and a nationally accredited continuing education course for pharmacists for the coming year.

The public education component of the DBND program will involve a TV commercial, to air in January 2006, a parent guide insert in the January 2006 edition of Today’s Parent magazine, Kid’s Cinema Slides in theatres throughout the province, and the availability of pamphlets and parent guides in public health clinics.

The DBND program incorporates teaching the three key messages to grade 2 students, day-care children, and their caregivers. The grade 2 program involves an interactive dialogue between students and the hand puppet, Bugsy. Bacteria and virus coloring sheets are used in a game. Other components include a hand washing demonstration using fluorescent lotion and a dark light, a skit, poems, and songs. The day-care program involves a Prop Box of age-appropriate activities for children, two children’s books, a handbook, a video for day-care workers, and a special hand washing poster. Both the grade 2 and day-care programs have a train-the-trainer component.

Regional deployment of the program is already underway in the Vancouver Coastal Health Authority, and the BCCDC program team will now work with other health authorities to facilitate the deployment of the program.

Visit our web site at www.dobugsneeddrugs.org for additional program information.

—David M. Patrick, MD, FRCPC, MHSc
UBC Centre for Disease Control
Director, Epidemiology Services

—Fawziah Marra, PharmD, FCSHP
UBC Centre for Disease Control
Director, Vaccine and Pharmacy Services

—Edith Blondel-Hill, MD, FRCPC
British Columbia Children’s Hospital
Medical Director, Do Bugs Need Drugs? Program

—Kim Dreher, RN, BScN
Program Coordinator, British Columbia
Do Bugs Need Drugs? Program
BC Centre for Disease Control

David M. Patrick, MD, FRCPC, MHSc, Fawziah Marra, PharmD, Edith Blondel-Hill, MD, FRCPC, Kim Dreher, RN, BScN. A community program for wise use of antibiotics. BCMJ, Vol. 47, No. 10, December, 2005, Page(s) 536 - BC Centre for Disease Control.

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