Use of antibiotics without a prescription is an understudied but serious issue in the US

Antibiotic use without a prescription is a “prevalent public health problem” in the US, according to a new metastudy.


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The use of antibiotics without a doctor’s prescription is an understudied but “prevalent” problem in the US, according to researchers from Baylor College of Medicine and the Center for Innovations in Quality, Effectiveness, and Safety. The team carried out a review of 31 previously-published studies on the topic to determine how frequent such use of antibiotics is in the US, and to examine the factors that lead to such usage of antibiotics.

Casually antibiotic

“Nonprescription antibiotic use is clearly a public health problem in all racial/ethnic groups, but many aspects are understudied,” the authors write. “The need to focus on nonprescription antibiotic use in community-based antimicrobial stewardship programs is urgent.”

The team, led by Larissa Grigoryan, M.D., Ph.D., from the Baylor College of Medicine in Houston, started with a body of 17,422 studies which they screened down (for relevance to this topic and other inclusion criteria) to 31. From these studies, the team report that nonprescription antibiotic use varies from 1% (among people who regularly visit a clinic when needed) to 66%, which was reported among Latino migrant workers. Another study found that around one quarter of its participants intended to use antibiotics without a prescription.

These antibiotics were sourced through various avenues, from saving leftover prescriptions, getting them from friends and family, or obtaining them from local markets “under the counter,” the authors explain. Findings from a scoping review are published in Annals of Internal Medicine. Anywhere from 14% to 48% of people — depending on population characteristics — store antibiotics for future use.

People turn to nonpescription use of antibiotics mainly due to lack of insurance or health care access, because they can’t afford the cost of a physician visit or prescription, due to embarrassment about seeking care for a sexually transmitted infection, or from not being able to get time off of work to visit a clinic or physician’s office, among several other reasons.

“In 2013, the U.S. Centers for Disease Control and Prevention (CDC) estimated that each year, 2 million infections caused by antimicrobial-resistant pathogens occur in the United States, resulting in 23,000 deaths,” Dr. Ayo Moses, a family physician with CareMount Medical in New York, told Healthline.

One of the main risks to public health regarding the nonprescription use of antibiotics has to do with the rise of bacterial antibiotic resistance. According to the European Antibiotic Awareness Day website, “if we take antibiotics repeatedly and improperly, we contribute to the increase in antibiotic-resistant bacteria, one of the world’s most pressing health problems,” adding that “if at some point in time you, your children or other family members need antibiotics, they may no longer work,” and that nonprescription use of antibiotics “is not a responsible use of antibiotics”.

On a personal level — if you’re don’t consider drug-resistant diseases a personal threat, that is — taking antibiotics isn’t guaranteed to make you feel better, and may actually cause side-effects. Antibiotics only work against bacteria, not against viruses, so diseases such as colds and flu will be totally unaffected. Taking antibiotics will not reduce the severity of your symptoms and will not help you feel better faster, while other over-the-counter medicine can. Taking antibiotics without a doctor’s supervision can even cause an infection to become more powerful.

On top of that, it’s important to keep in mind that any antibiotics you may stockpile can lose potency quickly — meaning they might not work anyway by the time you get to use them. So don’t rely on it!

The paper “Use of Antibiotics Without a Prescription in the U.S. Population” has been published in the journal Annals of Internal Medicine.

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