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The researchers collected data on the use of over-the-counter antibiotics in the United States from 31 studies conducted between 2000 and 2019 and focused on four main populations: patients outside one health care setting, patients in health facility, Hispanic populations and injecting drug users.
The use of non-prescription antibiotics included obtaining, storing, taking or intending to take antibiotics without medical advice. The prevalence of the use of over-the-counter antibiotics ranged from 1% (clinic patients) to 66% (Latin American migrant workers), while the intention of using antibiotics over-the-counter was 25% in the only study surveyed. Storage of antibiotics for future use ranged from 14% to 48% in all groups studied.
"We know that people are using antibiotics that have not been prescribed to them, which is neither safe nor good for health, so to solve this problem, we absolutely needed to know what was going on there. had already in the literature as well, we could identify gaps, "said Dr. Barbara Trautner, author of infectious disease research at Baylor College of Medicine and the Houston Veterans Affairs Medical Center, affiliated with the Center for Innovations in terms of quality and efficiency. and security.
One of these shortcomings was to determine the factors that drove people to self-treat and use over-the-counter antibiotics. The studies cited several factors, including insufficient access to health care, long wait times at the doctor's office, the cost of antibiotics and doctor visits, lack of transportation, and embarrbadment to the doctor. To obtain treatment for badually transmitted infections.
People received these over-the-counter antibiotics from a wide range of sources, including the remaining prescriptions and local markets that sold antibiotics as over-the-counter medications. Other sources were family and friends, flea markets, pet stores, health food stores and online sites. Most antibiotics came from remaining prescriptions, friends or family members.
"The overall picture presented here is much more detailed than I would have known, especially for the different sources," said Marc Lipsitch, professor of epidemiology at the Harvard TH Chan School of Public Health, who did not participate in the study. "For me, the important thing in this study is that [nonprescription antibiotic use] is a form of antibiotic use that contributes to the burden of antibiotic resistance. "
In the United States, the use of over-the-counter antibiotics has not been the subject of extensive studies, but studies in Europe have shown a link between high drug consumption over-the-counter and high antibiotic resistance, according to Dr. Larissa Grigoryan, lead author of the study and badistant professor in the Department of Family and Community Medicine at Baylor College of Medicine, also affiliated with the Center for Innovations in Medicine. quality, efficiency and safety.
Another problem related to the use of over-the-counter antibiotics is the risk of side effects. Antibiotics can cause "severe allergic reactions" or "microbiome disruption" when normal body bacteria are killed, Grigoryan said. A disrupted microbiome can allow bacteria such as Clostridium difficile to grow in areas previously occupied by normal bacteria and can lead to diarrhea and even death.
"People are clearly being pushed to take over-the-counter antibiotics because of concerns about their health or that of their family members and perhaps because they do not know that they might be putting in danger the health they're trying to help, "said Trautner. "If we do not correct the rising tide, we will see more and more [adverse effects]. "
The research had some limitations, including the fact that the 31 studies used different methods of collecting data through online surveys, telephone calls and the use of social media. In addition, some population subgroups were studied more than others, including the Hispanic population and injecting drug users.
Due to the diversity of data sources, "we can not present a single figure" that may indicate the amount of antibiotic use coming from over-the-counter medications, said Grigoryan.
This is why more in-depth research is needed to understand the scope of using over-the-counter antibiotics before correcting it.
"Antibiotics are one of the few medications where, if you take it, you can hurt others," Trautner said. "We want to reach out to people from multiple demographic groups – we need this information before we can design an intervention."
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