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Messages about appropriate antibiotic use must be responsive to ethnic differences and literacy issues

Overuse of antibiotics, partly driven by patients' pressure on doctors to prescribe them for conditions that don't warrant their use, has led to a growing problem of antibiotic-resistant infections. Public education campaigns about the appropriate use of antibiotics should be targeted to groups based on their educational level, English literacy, and ethnicity, according to a recent study that was supported in part by the Agency for Healthcare Research and Quality (HS13001). The study found population-based differences in knowledge about antibiotics between whites and Hispanics and between Spanish-language Hispanics and English-language Hispanics.

Kitty K. Corbett, Ph.D., M.P.H., of the University of Colorado, Denver, Ralph Gonzales, M.D., M.S.P.H., of the University of California, San Francisco, and their colleagues conducted a telephone survey in English or Spanish (as appropriate) of a random sample of 692 whites and 300 Hispanics in Colorado. They asked respondents about their knowledge of appropriate antibiotic use for colds and bronchitis.

Overall knowledge was low among those surveyed. In all comparisons, English-language Hispanics tended to reflect the response patterns of whites. About half (53 percent) of white respondents gave correct answers to questions about antibiotic use for colds compared with 43 percent of English-language Hispanics and 11 percent of Spanish-language Hispanics. In contrast, more Spanish-language Hispanics (37 percent) responded correctly to questions about use of antibiotics for bronchitis than English-language Hispanics (26 percent) and whites (22 percent). Also, 32 percent of Spanish-language Hispanics compared with 17 percent of English-language Hispanics and 15 percent of whites said they would be dissatisfied if they were not given an antibiotic for bronchitis. Antibiotics are accessible over the counter in Mexico and, for many newly arrived Hispanics of Mexican heritage, may be regarded as commonplace.

See "Appropriate antibiotic use: Variation in knowledge and awareness by Hispanic ethnicity and language," by Drs. Corbett and Gonzales, Bonnie A. Leeman-Castillo, M.S., and others in Preventive Medicine 40, pp. 162-169, 2005.

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