Research Leading to the Development of WARN

Community Intervention Trial

A study was conducted to assess the impact of parent and clinician education on pediatric antibiotic prescribing and carriage of penicillin-nonsusceptible Streptococcus pneumoniae in child care facilities. A non-randomized, controlled, community intervention trial was conducted in northern Wisconsin. Clinic staff received educational materials and small-group presentations; materials were distributed to parents through clinics, child care centers, and community organizations. This study concluded the following:

• A multifaceted educational program for clinicians and parents led to community-wide reductions in antibiotic prescribing.
• In child care facilities, there was no apparent impact on judicious antibiotic use or colonization with drug-resistant S pneumoniae.
• There is a need for specific educational interventions to promote appropriate antibiotic use for children in child care.
• Effective child care interventions may require repeated educational presentations for staff members and frequent reinforcement of key messages to parents.
• It is possible to change parental knowledge and awareness about antibiotic indications and antibiotic resistance with educational interventions directed at parents and clinicians.

Community intervention trial to promote judicious antibiotic use and reduce Penicillin-Resistant Streptococcus pneumoniae carriage in children. (Pediatrics. 2001 Sep;108(3):575-83.) Full text article

The effect of a community intervention trial on parental knowledge and awareness of antibiotic resistance and appropriate antibiotic use in children. (Pediatrics. 2001 Jan;107(1):E6.) Full text article

Measuring Antibiotic Susceptibility in Wisconsin, 1999

Streptococcus pneumoniae is a major cause of community-acquired infections in the United States, and rates of antibiotic resistance have increased in the past decade. Statewide rates of resistance to penicillin and other antibiotics have not been previously reported in Wisconsin. This study assessed invasive pneumococcal isolates for reduced susceptibility to nine different antibiotics. The study concluded that the proportion of invasive isolates with penicillin resistance in Wisconsin is similar to other regions of the United States. Inappropriate antibiotic use contributes to the emergence of resistant pneumococcal infections, and educational efforts are needed to promote judicious antibiotic use in Wisconsin.

Antibiotic susceptibility of invasive Streptococcus pneumoniae in Wisconsin, 1999 (WMJ. 2000 Aug;99(5):55-9.) Full text article (PDF)