Educational Brochure to Reduce Use of Antibiotics without a Prescription: A Pilot Study

BACKGROUND Non-prescription antibiotic use includes obtaining and taking antibiotics without a prescription, taking another person’s antibiotics, or taking one’s own stored antibiotics from previous prescriptions. Recent United States (U.S.) studies showed that 20–45% of the surveyed population reported prior non-prescription antibiotic use. This practice may lead to adverse drug reactions, diagnostic delays, Clostridium difficile infections, and contribute to rising antimicrobial resistance. To reduce this unsafe practice, we designed a patient-focused educational brochure in English and Spanish, informed by results from previous quantitative and qualitative studies. METHODS The brochure included information on safe means of obtaining antibiotics, antibiotic side effects, and non-antibiotic treatment of common symptoms. We iteratively revised the content incorporating stakeholder input from our community advisory board (CAB) and experts in health literacy and cultural competency for Hispanic communities. We tested the brochure’s acceptability, appropriateness, and usability using validated measures. Surveys were conducted from October 2023 to February 2024 among 100 patients in waiting rooms of two primary care clinics in Houston, TX. RESULTS Survey participants had a mean age of 53 years and were predominantly female (72%). The survey achieved a high response rate of 92%. Feedback on the brochure was overwhelmingly positive, with 98% finding it acceptable and appropriate, and 100% deeming it usable. Furthermore, 96% believed the brochure would be useful, citing content such as antibiotic indications (23%), over-the-counter alternatives (23%), and side effects (14%). Suggestions for improvement included providing alternative media formats and availability at pharmacies (27% each). CONCLUSION Our brochure may serve as an acceptable approach to educate patients about antibiotic use.