Study Reveals Growing Concern Over Increased Nonprescription Antibiotic Use

There is a growing concern among investigators surrounding the increased use of unprescribed antibiotics, which patients may obtain through various means, including saving leftover prescriptions for later use, getting the drugs from friends and family, or getting them “under the counter.”

Investigators at Baylor College of Medicine and the Center for Innovations in Quality, Effectiveness, and Safety reviewed 31 published studies to determine the prevalence of nonprescription antibiotic use in the United States and examined the factors that influence this use.

According to the press release, one in four patients had already used antibiotics without a prescription or intended to do so. Furthermore, approximately half of patients had stored antibiotics for future use or intended to do so, saving medicines prescribed for them or a family member.

Several factors, including a lack of insurance or health care access, cost of a physician or prescription, embarrassment about seeking care for a transmitted infection, and not being able to get time off of work to visit a clinic were among the cited reasons that contributed to nonprescription use.

The CDC estimates that at least 2 million people develop an antibiotic-resistant infection in the United States, of whom at least 23,000 people will die. Although a part of the high resistance rates can be traced to physicians overprescribing antibiotics for conditions such as common colds, influenza, sore throats or bronchitis, another cause is the increased rates of nonprescription use.²

A similar study conducted in 2016 found that within the population the authors examined, approximately 14% stored antibiotics at home and that the variety of nonprescription antibiotics were used from a range of different sources, with a store or pharmacy in the United States being the major source.³

According to the investigators, more studies are needed to quantitate nonprescription antibiotic use and explore potentially modifiable factors that contribute to unsafe practices.

References

• Use of Antibiotics Without a Prescription in the U.S. Population: A Scoping Review. Annals of Internal Medicine. Doi: 10.7326/M19-0505. Published July 23, 2019. https://annals.org/aim/article-abstract/2738922/use-antibiotics-without-prescription-u-s-population-scoping-review. Accessed July 24, 2019.
• Antibiotic/ Antimicrobial Resistance. CDC website. https://www.cdc.gov/drugresistance/index.html. Accessed July 24, 2019.
• Nonprescription Antimicrobial Use in a Primary Care Population in the United States. American Society for MicroBiology. doi: 10.1128/AAC.00528-16. Published September, 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997852/. Accessed July 24, 2019.