Nonprescription antibiotic use may be prevalent in the U.S. population
A scoping review of 31 studies found that up to 66% of patients reported using antibiotics without a prescription and that up to 48% were storing antibiotics for future use.
A substantial number of patients obtained antibiotics without a prescription and stored them for future use, a recent study found.
Researchers performed a scoping review of research published from January 2000 to March 2019 on the prevalence of nonprescription antibiotic use in the U.S. Overall, 31 articles were included. Results were published online on July 23 by Annals of Internal Medicine.
Results varied by characteristics of the study population. Prevalence of nonprescription antibiotic use varied from 1% (among patients visiting clinics) to 66% (among Latino migrant workers). Several studies reported that nonprescription antibiotic use was prevalent in Hispanic/Latino populations. In studies of injection drug users, the prevalence of nonprescription antibiotic use to treat abscesses and injection-related wounds varied from 5% to 32%.
Storage of antibiotics for future use varied from 14% to 48% in one 2018 survey of predominately white parents of young children. The survey found that of 219 (48%) parents who kept leftover antibiotics, 159 (73%) subsequently diverted them to their child's siblings, unrelated children, and unrelated adults. In another study, the prevalence of intention to use antibiotics without a prescription was 25%.
People reported obtaining antibiotics without a prescription from various sources, such as previously prescribed courses, local markets or stores, and family or friends. Reported factors contributing to nonprescription antibiotic use were easy access through markets or stores that obtain antibiotics internationally for under-the-counter sales, difficulty accessing the health care system, costs of physician visits, long waiting times in clinics, and transportation challenges.
The main limitation of the review is possible publication bias, the authors noted. They added that studies on the prevalence of nonprescription antibiotic use in the general U.S. population are lacking and that evidence on how to decrease such use is limited.
“Nonprescription antibiotic use is clearly a public health problem in all racial/ethnic groups, but many aspects are understudied,” they concluded. “The need to focus on nonprescription antibiotic use in community-based antimicrobial stewardship programs is urgent.”