Public health campaigns

Targeting behavioural factors that contribute to antibiotic resistance

A global and local health threat

Antibiotic resistance has been identified by the World Health Organisation as one of the greatest threats to human health today and requires action from government, health sectors and the community.

Australia is contributing to the problem of antibiotic resistance with one of the highest rates of antibiotic prescribing in the world:

  • approximately 19 million prescriptions written each year1
  • ranks number 8 among 29 countries evaluated2
  • 46% of people were dispensed at least 1 course of antibiotics in 20143

Consumer and GP insights

Audience research conducted by NPS MedicineWise identified multiple gaps in knowledge, beliefs and behaviours that are driving inappropriate prescribing and use of antibiotics in Australia.

Parental expectation for antibiotics is an ongoing challenge faced in general practice. Most parents believe that antibiotics are beneficial for childhood respiratory tract infections (RTIs) such colds, coughs, earaches and sore throats. Many parents also equate the duration of common childhood RTIs with the need for antibiotics.4,5 A survey conducted by NPS MedicineWise found that 40% of Australian general practitioners (GPs) would prescribe antibiotics to meet patient expectations.6

Antibiotics are generally not recommended for common RTIs.7–10 Yet analyses of MedicineInsight data showed over 50% of patients with RTIs were unnecessarily prescribed antibiotics in 201511, highlighting the need to manage patient expectation for antibiotics and reinforce guidelines for prescribing in general practice.


NPS MedicineWise national campaign to reduce unnecessary antibiotic prescribing

In 2012, NPS MedicineWise made a commitment to deliver a 5-year public health campaign that achieves the following strategic imperatives:

  • address the knowledge, beliefs and behavioural factors driving consumer expectation and demand for antibiotics
  • support GPs in managing consumer expectations for antibiotics through the provision of patient consultation tools that reinforce guidelines-based management of common RTIs
  • reduce inappropriate prescribing and use of antibiotics for common RTIs and in turn the development of antibiotic resistance.

Phase 1 plan (2013–2016)

Raise general awareness and improve knowledge about antibiotic resistance, resistant bacteria, limitations of antibiotics on cold and flu viruses and appropriate use:

  • knowledge that bacteria is becoming resistant
  • awareness that antibiotic resistance is happening now
  • knowledge that antibiotic resistance can be passed between people
  • that antibiotics will not speed up recovery from cold and flu
  • how misuse of antibiotics can lead to antibiotic resistance.

Phase 2 plan (2017)

Provide patient support and education to address key concepts in appropriate RTI symptom management and expectation for antibiotics:

  • Duration of RTI symptoms
  • Speed of recovery from RTIs
  • RTI symptom management without antibiotics
  • Expectation for antibiotics


Over 5 years the public health campaign was implemented with various behaviour change interventions and key messages across multiple channels:

  • Patient-mediated educational resources in general practices, pharmacies and communities
  • General practice resource kits including patient consultation tools
  • Consumer mass media campaigns including TV, news and public relations
  • Social media campaigns including educational videos and quizzes
  • Clinical guidelines and patient education via NPS MedicineWise website

Evaluation results

Consumer awareness of antibiotic resistance:

  • the proportion of consumers who believe antibiotic resistance affects them now increased from 11% in 2015 to 25% in 2017¹².

Changes in GP prescribing and decision making:

  • 16% increase in proportion of GPs who did not prescribe antibiotics to meet patient expectations (p<0.001)12
  • 14% increase in proportion of GPs who discussed the issue of antibiotic resistance with their patients (p<0.001)12

Reduction in prescribing:*

  • 14% total reduction in total dispensed antibiotics prescriptions13
  • 1.3 million average annual reduction in dispensed antibiotics prescriptions12

Savings for the Australian health system:

  • $48.8 million in total Pharmaceutical Benefits Scheme (PBS) cost savings12
  • $12.2 million in annual PBS cost savings12


Reducing antibiotic resistance is complex, multifaceted and requires ongoing communication strategies and interventions to address multiple behavioural factors from both the consumer and health professional perspectives.

  1. OECD. Antimicrobial resistance. Paris: OECD, 2018.
  2. Australian Commission on Safety and Quality in Health Care. AURA 2016: first Australian report on antimicrobial use and resistance in human health. Sydney: ACSQHC, 2016.
  3. Gaarslev C et al. A mixed methods study to understand patient expectations for antibiotics for an upper respiratory tract infection. Antimicrob Resist Infect Control. 2016;5:39.
  4. Coxeter PD et al. Parents’ expectations and experiences of antibiotics for acute respiratory infections in primary care. Ann Fam Med 2017;15:149-154.
  5. Spinks A et al. Antibiotics for sore throat. Cochrane Database Syst Rev 2013;11:CD000023
  6. Venekamp RP et al. Antibiotics for acute otitis media in children. Cochrane Database Syst Rev 2015;6:CD000219
  7. Smith SM et al. Antibiotics for acute bronchitis. Cochrane Database Syst Rev 2014;3:CD000245
  8. Lemiengre MB et al. Antibiotics for clinically diagnosed acute rhinosinusitis in adults. Cochrane Database Syst Rev 2012;10:CD006089
  9. Wu J et al. Relationship between antimicrobial-resistance programs and antibiotic dispensing for upperrespiratory tract infection: An analysis of Australian data between 2004 and 2015. J Int Med Res. 2018;46(4):1326–1338

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