The study of $149,800 over three years will assess antibiotic usage that includes a survey of residents, in-depth interviews with health care providers and an analysis of prescription data in 24 village clinics, 12 township hospitals, and 3 county hospitals in rural Shandong. Its findings will be used to devise an educational intervention for health care providers aimed at improving the rational use of antibiotics. After implementing the intervention for 12 months in half of the sites the baseline assessments will be repeated and changes between intervention and control communities will be compared.