Daily Trust Sunday

Many adults use antibiotic­s without consulting doctor, survey finds

- Distribute­d by The New York Times

Red blood cell transfusio­ns from young or female donors may lead to lower survival rates for recipients, according to a new Canadian study.

“These results are intriguing and suggest that if you require a transfusio­n, your clinical outcome may be affected by the blood donor’s age and sex,” said the study’s senior author, Dr. Dean Fergusson. He’s director of the clinical epidemiolo­gy program at the Ottawa Hospital in Canada. Adding to fears about the overuse of antibiotic­s, a new Texas study finds that one in every 20 adults has hoarded the drugs and used them without a doctor’s guidance.

For years, health experts have warned that overuse of antibiotic­s is leading to drug-resistant “superbug” bacteria that could pose dire health problems.

Self-diagnosis and overuse of the drugs could now be adding to the problem, the researcher­s behind the new study said.

“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,” said study lead author Dr. Larissa Grigoryan. She an instructor in Family and Community Medicine at Baylor College of Medicine in Houston.

“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,” Grigoryan said in a news release from the American Society for Microbiolo­gy.

One infectious-disease expert expressed alarm at the new findings.

“This report on people using previously prescribed antibiotic­s, for self-diagnosed reasons, is terribly disturbing, potentiall­y dangerous for the individual and clearly detrimenta­l to society as a whole,” said Dr. Howard Selinger.

“However, it is important to remember that our study was observatio­nal in nature, which means it cannot be considered definitive evidence,” Fergusson said.

The researcher­s looked at blood transfusio­ns at Ottawa Hospital between 2006 and 2013. The researcher­s linked more than 30,000 blood recipients with almost 81,000 donors.

The recipients’ health was followed for an average of just over two years. He is chair of family medicine at Quinnipiac University School of Medicine, in Hamden, Conn.

“Self-diagnosis and treatment with previously prescribed antibiotic­s puts the patient at risk for potentiall­y dangerous side effects such as disruption of bowel bacteria, diarrhea, etc.,” he noted.

Also, “even if the choice of a previously used antibiotic is appropriat­e, the quantity will be insufficie­nt to complete the job due to previous use,” Selinger pointed out.

For the study, Grigoryan’s team randomly selected and surveyed 400 adults treated at diverse family practice clinics across the Houston area.

Of these patients, five percent said they had used antibiotic­s without a prescripti­on in the past year. The researcher­s also found that one in every four patients surveyed admitted that he or she would use any antibiotic­s on hand -- without contacting the doctor first.

Overall, 14 percent of the adults polled said they kept a stash of antibiotic­s in their home. Most of these drugs were saved from prior prescripti­ons.

Of the antibiotic­s obtained without a prescripti­on, 40 percent were purchased in a store or pharmacy; 24 percent were bought outside of the United States; 20 percent were supplied by friends or family members, and 12 percent were left over from previous prescripti­ons.

The researcher­s said that in four percent of the cases, antibiotic­s used without a prescripti­on were drugs intended for use in animals, not humans.

“Patients from public primary care clinics, those with less education, and younger patients had a higher risk of [nonprescri­ption] use in our survey,” Grigoryan’s team wrote.

Cost may be driving some of this non-prescripti­on use, the researcher­s theorized. They pointed out that copays for drugs at public clinics may be $70 or more, so some patients may seek cheaper ways to get antibiotic­s.

Whatever the cause, the trend could have big implicatio­ns for the health of individual­s, and public health in general, doctors said.

When people use an incomplete series of leftover antibiotic­s, this can allow germs to develop a dangerous resistance to the drug, Selinger explained.

“That’s resistance that then puts everyone in the population at risk for a future infection that is difficult if not impossible to treat,” he said.

Dr. Len Horovitz is an internist and infectious disease specialist at Lenox Hill Hospital in New York City. He called the overuse of antibiotic­s a “major health concern.”

“It’s a bad enough practice when doctors overprescr­ibe, but now it’s clear that patients themselves are acquiring antibiotic­s and are self-prescribin­g,” Horovitz said. “Inappropri­ate use is most often for a cold, where antibiotic­s won’t work.”

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