Open Access Open Badges Research article

Promoting prudent use of antibiotics: the experience from a multifaceted regional campaign in Greece

Diamantis Plachouras1*, Anastasia Antoniadou1, Efthymia Giannitsioti1, Lambrini Galani3, Ioannis Katsarolis1, Dimitra Kavatha1, George Koukos1, Periklis Panagopoulos1, Antonios Papadopoulos1, Garyphalia Poulakou1, Vissaria Sakka1, Maria Souli1, Styliani Sybardi2, Sotirios Tsiodras1, Kyriaki Kanellakopoulou1 and Helen Giamarellou3

Author Affiliations

1 4th Department of Internal Medicine, University Hospital « Attikon », 1 Rimini Avenue, 12462 Haidari, Athens, Greece

2 Department of Internal Medicine, Thriassio General Hospital, Elefsina, Greece

3 6th Department of Internal Medicine, Hygeia General Hospital, Marousi, Athens, Greece

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BMC Public Health 2014, 14:866  doi:10.1186/1471-2458-14-866

Published: 22 August 2014



Antibiotic resistance, a major public health problem, has been linked to antibiotic consumption. In Greece both consumption and resistance rates are among the highest in Europe. A multifaceted campaign targeting both physicians and parents of school children was implemented for the first time in order to educate the public and update doctors, aiming to promote judicious use of antibiotics and hopefully decrease its consumption.


The programme consisted of a public education campaign and academic detailing of primary care physicians in the district of Corinth in Peloponnese. The experience and perceptions of parents were recorded in the meetings in the form of course evaluation and assessment, anonymous questionnaires. The use of Rapid Antigen Detection Test (RADT) for streptococcal pharyngitis by primary care physicians was also assessed by use of anonymous questionnaires. Antibiotic consumption was compared before and after the programme between the district of Corinth and the other districts of Peloponnese, as well as at a national level.


Antibiotic consumption remained unaltered at 26 Defined daily doses per 1000 Inhabitants per Day (DID) in accordance with the trend in other regions and at a national level. However, the utilization of Amoxycillin and Penicillin was increased by 34.3%, while the use of other antimicrobial classes including macrolides, cephalosporins and fluoroquinolones decreased by 6.4-21.9%. The use of RADT did not lead to a significantly decreased antimicrobial consumption.


A multifaceted educational programme targeting both the general public and primary care physicians was associated with rationalization in the choice of antimicrobial. A reduction in the total antimicrobial consumption was not achieved.

Antimicrobial consumption; Academic detailing; Public education