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IDSA warns against pharmacies offering free antibiotics
IDSA: Free influenza vaccinations would be more beneficial.
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The Infectious Diseases Society of America has warned grocery-store pharmacies that free antibiotic giveaways may endanger customers and become a serious public health threat.
Grocery stores such as Giant, Publix Super Markets, Stop & Shop and Wegman’s have offered free antibiotics to customers. All of those stores provided amoxicillin, cephalexin, sulfamethoxazole/trimethoprim, ciprofloxacin, penicillin, ampicillin and erythromycin. Giant and Wegman’s also offered doxycycline hyclate and Wegman’s offered tetracycline.
Customers can receive up to 14 days’ worth of antibiotics. In some cases, there are no limits to the number of prescriptions that can be filled.
Executives from Giant said the program will breed goodwill among its shoppers, and described the offer as good citizenship.
Officials at the IDSA said these programs may have long-term detrimental effects on public health. “While it may make good marketing sense, promoting antibiotics at a time when we are facing a crisis of antibiotic resistance does not make good public health sense,” Anne Gershon, MD, IDSA president, said in a press release. “On the other hand, grocery stores would be doing a tremendous service if they help more people get their influenza shots.”
Gershon and others at the IDSA said free influenza vaccinations would be a much more beneficial public health service. Free influenza vaccination could help customers save money and reduce the risk of illness. In addition, excessive use of antibiotics is associated with reduced efficacy. There is no such association for influenza vaccination.
“Lowering customers’ health care costs is an admirable goal,” Gershon said. “But singling out antibiotics for promotion when we are facing a crisis of antibiotic resistance is the wrong way to do it. On the other hand, free influenza vaccinations could make a real contribution to public health.” – by Rob Volansky
In this day and age, giving away free antibiotics, even after a physician writes a prescription for them, makes infectious disease physicians shudder, and rightly so. What we do not need is more antibiotics contributing to the already large pool of antibiotic pressure promoting the development of more antimicrobial resistance. Therefore, I am completely in support of the IDSA position, as stated in their press release.
Note, however, that the IDSA is, in a sense, caught between a rock and a hard place here. The message from the IDSA simply does not play that well with the public. The public sees just what the grocery store CEOs hope they will: a generous act on the part of the supermarket managers that brings shoppers into their stores. Never mind that the particular antibiotics being dispensed happen to be very cheap, and it costs the supermarkets little to do this.
The alternative suggested by the IDSA — a free influenza vaccine — is a great suggestion. However, the influenza vaccine is really much more expensive than 14 days' worth of amoxicillin, especially after one factors in administration costs. Realistically, the best the supermarkets could do would be to offer influenza vaccine at a reduced cost, perhaps half of the going retail price. Without running the numbers, I am not sure how feasible this might be, but I fear that for the public it would not carry the panache of something like free antibiotics. Yet it would still bring many customers into their stores.
There will be adverse impacts to this. They will include specific drug-related adverse effects and the microbiologic adverse effects that we as physicians are concerned with. Our message, I believe, should be directed primarily to supermarket management and should point out that this is really quite irresponsible in this era of rampant antimicrobial resistance. There are many more beneficial things they could do to bring the public into their stores.
Sadly, as we are just now learning from the Peanut Corporation of America management, public health issues do not drive decision-making. Greed rules.
– Theodore Eickhoff, MD
Infectious Disease News Chief Medical Editor