Houston—A rarely recognized problem appears to be fueling the spread of antibiotic resistance: Patients who use antibiotics without a prescription.
An article published recently in the journal Antimicrobial Agents and Chemotherapy notes that 5% of adults from a cohort of 400 patients reported using antibiotics without a prescription during the previous 12 months, with a fourth of them reporting that they would use antibiotics without contacting a medical professional.
The responses were from a random sample of socioeconomically and ethnically diverse adult patients of family practice clinics in the Houston area, according to the Baylor College of Medicine–led study.
Researchers report that:
• 14% of the patients reported keeping a stash of antibiotics at home;
• 40% were purchased in stores and pharmacies in the United States;
• 24% were obtained outside of the U.S.;
• 20% were supplied by friends or relatives; and
• 4% of the total were veterinary antibiotics.
Leftover medicines from previous prescriptions accounted for 12% overall, with those making up 74% of the antibiotics patients were storing.
“The most common conditions patients reported self-treating with antibiotics were sore throat, runny nose, or cough—conditions that typically would get better without any antibiotic treatment,” explained corresponding author Larisa Grigoryan, MD, PhD, an instructor in the Department of Family and Community Medicine at Baylor. She added that rates of self-treatment with antibiotics were similar across different races and ethnic groups.
Of the patients who said they would use antibiotics without a prescription, however, 60% were from public clinics that provide care for underserved minority patients, and 44% reported annual incomes of less than $20,000, Grigoryan noted.
“Patients from public primary care clinics, those with less education, and younger patients had a higher risk of [non-prescription] use in our survey,” the investigators write, adding that one motivation for self-prescribing might be to save money on drugs and on copays, which could range up to more than $70.
“When people self-diagnose and self-prescribe antibiotics it is likely that the therapy is unnecessary because most often these are upper respiratory infections that are mostly caused by viruses,”
Grigoryan pointed out, adding that, even in the case of bacterial infections, “lay people don’t know which antibiotics cover which pathogens and for how long should they use them.” Resistance can be fostered when antibiotics are misused so that some of the pathogenic bacteria survive, she added.
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