Non-prescription antimicrobial use in a primary care population in the United States: evidence for action.
Antimicrob Agents Chemother. 2016 Jul 11;
Authors: Zoorob R, Grigoryan L, Nash S, Trautner BW
Community antimicrobial resistance is high in communities with frequent use of non-prescription antibiotics. Studies addressing non-prescription antibiotic use in the United States (US) have been restricted to Latin American immigrants. We estimated the prevalence of non-prescription antibiotic use in the previous 12 months, as well as intended use (intention to use antibiotics without a prescription) and storage of antibiotics, and examined patient characteristics associated with non-prescription use in a random sample of adults.We selected private and public primary care clinics that serve ethnically and socioeconomically diverse patients. Within the clinics, we used race/ethnicity stratified systematic random sampling to choose a random sample of primary care patients. We used a self-administered standardized questionnaire on antibiotic use. Multivariate regression analysis was used to identify independent predictors of non-prescription use.The response rate was 94%. Of 400 respondents, 20 (5%) reported non-prescription use of systemic antibiotics in the last 12 months, 102 (25.4%) reported intended use and 57 (14.2%) stored antibiotics at home. These rates were similar across race/ethnicity groups. Sources of antibiotics used without prescriptions or stored for future use were stores or pharmacies in the US, "leftover" antibiotics from previous prescriptions, antibiotics obtained abroad, or from a relative or friend. Respiratory symptoms were common reasons for using non-prescription antibiotics. In multivariate analysis, public clinic patients, those with less education, and younger patients were more likely to endorse intended use.The problem of non-prescription use is not confined to Latino communities. Community antimicrobial stewardship must include a focus on non-prescription antibiotics.
PMID: 27401572 [PubMed - as supplied by publisher]