Tag Archives: prescription

Antibiotics.

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.

Antibiotics.

Image via Pixabay.

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.

Prescribing fruits and veggies to children has lasting positive effects

Should fruits and veggies be prescribed just like medicine? These researchers believe that at least in some cases, the answer is yes.

Should we be prescribing fruits?

In 2015, the Hurley Children’s Center in Michigan was relocated to the second floor of the downtown Flint Farmers’ Market. The center, which is associated with Michigan State University College of Human Medicine, wanted to take advantage of this and launched a program to encourage families to shop at the farmers market. So they started a program in which they would give families a $15 prescription, redeemable at the market.

This is particularly important in places like Flint, which are considered urban food deserts: places where people can’t afford and/or don’t have much access to healthy foods. About 60% of the city’s children live in poverty, and most of them get their calories from low-quality, sugar-rich, and fat-rich sources. There aren’t even that many grocery stores in the city.

All in all, the conditions are ripe for an unhealthy eating epidemic — and doctors wanted to deal with it as you would with any other medical problem.

“Fruit and vegetable intake tracks from childhood to adulthood, making it important for healthcare professionals to guide children towards healthy eating early on,” said lead researcher Amy Saxe-Custack, assistant professor at Michigan State University and nutrition director of the Michigan State University-Hurley Children’s Hospital Pediatric Public Health Initiative. “We need to consider not only nutrition education but also barriers to access and affordability of fresh fruits and vegetables, particularly in underserved areas. The prescription program is a first step to introducing fresh, high-quality produce to children.”

In a new study, Saxe-Custack and her colleagues present the results of this approach. They carried out interviews with parents from Flint, finding that those who had received the $15 prescription were much more likely to shop at the farmers market than the ones who hadn’t. In other words, families who were once given the opportunity to eat healthy food for free were much more likely to start paying for healthy food. They were also more concerned with the overall dietary patterns of their children.

“The caregivers shared their heartfelt appreciation for the physicians and medical staff who introduced the prescriptions,” said Saxe-Custack. “Some talked about how they enjoy visiting the farmers’ market with their kids and guiding the children to use the prescriptions for their favorite fruits and vegetables. Others described how they hold on to the prescriptions until they reach $30 to $40 and redeem them at the market when food dollars are limited.”

Of course, access to healthy food remains a problem — especially as, in many cases, healthy food is much more expensive than cheaper, less healthy alternatives. But if a prescription can convince parents to at least try and give their children healthy foods, why not try it?

The results will be presented at the Nutrition 2018 conference. The paper has not been peer-reviewed yet.