1. Presented by: Alexa DiGaetano, Russel Turco, Erica Bliszcz, Chelsey Kiefer, Alyssa Bartels, Kara Nesbitt

2. Antibiotics: one of the scientific breakthroughs of the 20 th century Early 1900’s: no medicines against common germs Before antibiotics, 90% of children with bacterial meningitis died Strep throat considered a fatal disease Other serious infections caused by aggressive bacteria reproduced with extraordinary speed and led to serious illness/death

3. First antibiotic: Penicillin From nearly the start, doctors noticed Penicillin was not useful against certain strains of Staphylococcus aureus (bacteria that causes skin infections). As of 2009, most popular for kids: Amoxicillin

4. Children take too many antibiotics due to doctors overprescribing them, even when antibiotics may not cure the illness. Parents do not know the difference between viruses and bacterial infections. Antibiotic resistance continues to increase.

5. Pharmacy Database Audit 200,000 prescriptions Results 40,000 or 20% of prescriptions given to children with viral illness

6. Experiment 1,556 Parents: Group A (control) 886 parents Group B (experimental) 886 parents Experiment Results Group A: No parents asked about antibiotics Group B: 81% of parents asked doctors about reasoning for antibiotics and other organic remedies.

7. Survey of American pediatricians: 40%- parents requested antibiotics 30%- physicians complied knowing they weren’t needed Overuse of antibiotics links to antimicrobial resistance 21%- pediatric ambulatory visits result in antibiotic prescription 70%- antibiotic prescribed was unnecessary 23%- unnecessary antibiotic prescriptions for respiratory visits Concerns of “superbugs” emerging

8. Studies show parents provided with information prior to children becoming ill resulted in a 16% decrease of consultations for sore throat 13% for cough 40% consultation decrease per person/year Interventions prove more effective when given to parents and children Written information with focused content remains more effective than generic messages

9. Report Audit by Pediatrics 1993-2008 24% drop in antibiotics for respiratory infections 19% drop in antibiotics for colds Overall, 58% children prescribed antibiotics actually had a respiratory infection 2011 Greater than 50% of all prescriptions written for children 14 and under deemed unnecessary Parents of infants demand antibiotics-difficult for doctors to refuse

10. External Doctors Health Professionals -Nurse practitioners, physician’s assistants Parents Caretakers Intermediary Doctors Health Professionals -Nurse practitioners, physician’s assistants Lifestyle and Nutrition sections in various health media Internal Doctors Board Members Special Drug Makers/Drug Reps Government Agencies (FDA, ACF, CDC) Lifestyle and Nutrition sections in various health media

11. Must Influence (Priority Target) Should Influence (Secondary Target) Doctors Parents Caretakers Board Members Lifestyle and Nutrition sections in various health media Government Agencies (FDA, ACF, CDC) Drug Reps/Companies Maximum PR EffortSignificant PR Effort Likely to Influence Unlikely to Influence

12. MessageAudienceChannel Write fewer antibiotic prescriptions and help end the problem of children becoming antibiotic- resistant. Doctors, Health Professionals trade shows, pamphlets, luncheons, e-mail campaign, webinars Learn the difference between viruses and bacterial infections to help end the problem of children becoming antibiotic- resistant. Parents, Caregivers, Government Agencies pamphlets, webinars, radio broadcasts Parents and doctors need to reduce the amount of antibiotics taken by children to help end the problem of children becoming antibiotic-resistant. Health Medianews releases Encourage doctors to use drugs only when necessary and become respected ethically. Drug Repsnews releases, luncheons, events

13. Objective 1.0 Reduce the number of antibiotics prescribed to children in the U.S. by 10% in one year. Strategy 1.1 Refresh doctor knowledge on differences between viruses and bacterial infections to reduce the number of prescriptions written. Tactic 1.1.1 Trade show with speaker Tactic 1.2.1 Newsletters Tactic 1.3.1 Direct Mail  -Letter describing health concern  -Insert

14. Objective 2.0 Increase parents’ understanding of viruses versus bacterial infections by 25% within three months. Strategy 2.1 Provide parents with educational material to reduce the number of doctor visits that lead to prescriptions for antibiotics. Tactic 2.1.1 Create and launch an informational web campaign. Tactic 2.1.2 Medical brochure explaining differences between viruses and bacterial infections Tactic 2.1.3 Question and answer sessions with medical expert

15. Objective 3.0 Increase media awareness by publishing articles in one out of ten outlets that receive information. Strategy 3.1 Highlight health risks of children taking too many antibiotics to increase interest of parents. Tactic 3.1.1 Editor lunch-ins Tactic 3.1.2 News releases Tactic 3.1.3 Commercials

16. ActivityEstimated Cost Website Launch$8,000 Pamphlets $5,000 Research$100,000 Radio Broadcast$20,000 Trade Shows (10)$100,000 Speakers (webinars, tradeshows) $300,000 E-mail Campaigns$500 Luncheons$50,000 FINAL COST:$583,500

17. Objective 1.0 Reduce the number of antibiotics prescribed to children in the U.S. by 10% in one year. – MET Refreshed doctors’ knowledge Increased attendance 20% of doctors attended

18. Objective 2.0 Increase parents’ understanding of viruses versus bacterial infections by 25% within three months. – MET Provide parents with educational information Web campaign Successful; reached a total of 50% of our target audience Brochure with difference between viral and bacterial infections 60% of parents questioned the need for antibiotics Q&A session Health professionals answered all questions parents had

19. Objective 3.0 Increase media awareness by publishing articles in one out of ten outlets that receive information. – MET Highlight antibiotic resistance in children. Editor luncheons Total of 50 editors attended News release Pitched to 50 different publications, 35 picked it up Radio broadcast

20. Loyalties Yes – Increase revenue – keeping the company in existence. No – Over-prescribing antibiotics to children is wrong. Principles Yes – Aristotle’s Golden Mean: “Greatest good for the greatest number.” Mill’s Principle of Utility: “What is useful is right” No - Rawl’s Veil of Ignorance: “Eliminate roles to justly decide.” Values Yes – Antibiotics decrease sickness and make people feel they received accurate treatment. No – Honesty and integrity are more important than comforting parents with antibiotics. Definition Yes – Antibiotics help children get better and decrease parental concern. No – Children should not be take an abundant number of antibiotics due to health risks. Is it ethical to over-prescribe antibiotics to children to please parents?