Tessa Jaqua is a public health educator and the program coordinator of the Oregon Alliance Working for Antibiotic Resistance Education for the Oregon Health Authority. Tessa has a background in lifespan public health, bringing experience from maternal and childhood health, gerontology, immunizations, and emergency preparedness in both the public and private sectors.

Lately, antibiotic resistance has been making national headlines. Considering it is one of the world’s most pressing public health threats, the increased awareness is welcome to those of us in public health, who have been fighting on the frontlines in the war against antibiotic resistance for more than a decade.

The Oregon Alliance Working for Antibiotic Resistance Education’s (AWARE) mission is to encourage the appropriate use of antibiotics and aims to reduce the problem of antibiotic-resistant bacteria in Oregon. With funding from the Centers for Disease Control and Prevention’s (CDC) Get Smart: Know When Antibiotics Work Program, this coalition of over 50 state-wide partners works to raise public and professional awareness about using antibiotics wisely. In order to accomplish this, it enlists the aid of community-based organizations to reduce the unnecessary use of antibiotics and promote self-care for viral illnesses.  The coalition focuses its efforts on three target audiences, including the general public, healthcare providers, and educators to create a consistent and holistic message.

For the general public, this state-wide program provides year-round outreach and seasonal marketing campaigns surrounding Get Smart About Antibiotics Week. It offers free educational materials on the effects of antibiotic resistance on the individual/community to businesses, child care providers, and others. The materials also explain the importance of self-care in the event of viral illness. Oregon AWARE also attends health fairs, farmers markets, and health and wellness events around the state to encourage the following messages:

• Using antibiotics for viral infections like colds or flu have no effect and can cause serious side effects.
• Taking antibiotics when they’re not necessary puts members of the community at risk for developing resistant infections.
• Finishing a prescribed antibiotic even if symptoms have lessened or disappeared is advised.
• Avoid sharing antibiotics, taking leftover antibiotics, or using them without a prescription.

Since the coalition’s inception in 2001, Oregon AWARE’s primary focus has been its work with healthcare providers. Though Oregon’s rates of antibiotic resistance are low compared to other states, Oregon AWARE understands that resistance anywhere is resistance everywhere. The inappropriate prescription of antibiotics and the gross overuse of broad spectrum drugs, which are antibiotics that are effective on multiple organisms rather than gram negative organisms only, are still a pervasive problem throughout the state. To target these issues, Oregon AWARE uses a two-pronged approach to reach providers. First, by working with Pacific University Pharmacy program, Oregon State University Pharmacy program, and the Oregon Health and Science University Physician Assistants program, Oregon AWARE helps to educate future providers on the importance of judicious antibiotic use while training them to be AWARE certified educators. This allows the providers-in-training to utilize their education and AWARE education at their respective internships and at community functions like the annual “AWARE on the Square” event during Get Smart About Antibiotics Week. Reaching the network of practicing providers is accomplished through an annual promotional mailing, which includes promotional materials and patient education resources. The coalition released the 3rd edition of the Judicious Use of Antibiotics: A Guide for Oregon Clinicians, a comprehensive guide to treating the five major upper respiratory infections; the guide includes detailed treatment algorithms and an opportunity for CE/CME credit for Physicians, Physician Assistants, Nurses, and Pharmacists. Working with both future and current healthcare professionals solidifies that these key messages are consistent and impactful:

• Research shows that adverse health outcomes are rare when providers are conservative in prescribing of antibiotics.
• Patient satisfaction increases due to providers’ commitment to educating patients about self-care and symptom management. Furthermore, patient satisfaction does not increase by fulfilling a patient’s or parent’s expectation of receiving an antibiotic prescription.

In order to better reach younger antibiotic consumers and expand the scope of the program’s messaging, Oregon AWARE in partnership with other Get Smart grantees developed curricula on antibiotic resistance for grades K-3, 4-6, and 9-10. The program uses the curricula to provide in-person group trainings or individual training to all schools in the state of Oregon. Since their introduction, these curricula have been used in over 35 Oregon school districts, and have been the means of training over 75 nursing, pharmacy, physician assistant, public health, and medical students as AWARE educators to increase access to antibiotic resistance education.

Oregon AWARE understands and strives to promote the idea that we all have a role in preventing antimicrobial resistance. Patients, public health workers, healthcare providers, hospital administrators, industry, policy makers and the general public can work together to promote appropriate antimicrobial use – ultimately saving lives.