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JAC Advance Access originally published online on December 18, 2008
Journal of Antimicrobial Chemotherapy 2009 63(2):230-237; doi:10.1093/jac/dkn508
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Leading articles

Sustainability for behaviour change in the fight against antibiotic resistance: a social marketing framework

Timothy Edgar1,*, Stephanie D. Boyd2 and Megan J. Palamé1

1 Department of Communication Sciences and Disorders, Emerson College, 120 Boylston Street, Boston, MA 02116, USA 2 Alliance for the Prudent Use of Antibiotics, 2nd Floor, 75 Kneeland Street, Boston, MA 02111, USA


* Corresponding author. Tel: +1-617-824-8743; Fax: +1-617-824-8735; E-mail: timothy_edgar{at}emerson.edu

Antibiotic resistance is one of today's most urgent public health problems, threatening to undermine the effectiveness of infectious disease treatment in every country of the world. Specific individual behaviours such as not taking the entire antibiotic regimen and skipping doses contribute to resistance development as does the taking of antibiotics for colds and other illnesses that antibiotics cannot treat. Antibiotic resistance is as much a societal problem as it is an individual one; if mass behaviour change across the population does not occur, the problem of resistance cannot be mitigated at community levels. The problem is one that potentially can be solved if both providers and patients become sufficiently aware of the issue and if they engage in appropriate behaviours. Although a number of initiatives have been implemented in various parts of the world to elicit behaviour change, results have been mixed, and there is little evidence that trial programmes with positive outcomes serve as models of sustainability. In recent years, several scholars have suggested social marketing as the framework for behaviour change that has the greatest chance of sustained success, but the antibiotic resistance literature provides no specifics for how the principles of social marketing should be applied. This paper provides an overview of previous communication-based initiatives and offers a detailed approach to social marketing to guide future efforts.

Keywords: campaigns , communication , interventions , audiences


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