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Survey finds risky antibiotic use among adults
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The University of Michigan National Poll on Healthy Aging surveyed a national sample of U.S. adults about their opinions and experiences with antibiotics and found that nearly half expected antibiotic prescriptions at doctor visits and more than half have taken leftover antibiotics without talking to a health care professional.
More than half said they believe doctors overprescribe antibiotics, but many still expect to receive them for long-lasting colds or influenza-like illnesses.
“This report is one of 22 to date related to the National Poll on Healthy Aging,” Preeti Malani, MD, a professor of medicine in the division of infectious diseases and chief health officer at the University of Michigan, told Infectious Disease News. “Given how common antibiotic use is, the poll team wanted to ask about use, concerns, and beliefs.”
Malani and colleagues administered the survey online to 2,256 randomly selected adults aged 50 to 80 years in May 2019. The survey focused on several different areas, including use of antibiotics and leftover medication, taking antibiotics without a prescription and perceptions about antibiotics.
According to the survey, 48% of respondents reported filling a prescription for antibiotics in the last 2 years, most commonly for respiratory infections (50%), dental infections (18%), UTIs (17%) and skin infections (11%). One in eight respondents had leftover medication and cited having more doses than needed (34%), feeling better (32%), side effects (18%), forgetting or skipping doses (14%) and lack of efficacy (7%) as reasons for having leftovers.
According to the survey, 65% of these adults kept the leftover antibiotics, 20% threw them away or flushed them, and 15% did not specify. The rest reported keeping their extra antibiotics in case they acquired another infection (60%), in case a family member got an infection (4%) or because they forgot to or did not know how to dispose of them (6%).
Malani said one solution for solving the issue of antibiotic misuse is making sure patients do not save extra antibiotics. She said providers should be mindful about the number of pills prescribed, to minimize extra doses and leftovers, and should discuss with patients what to do with extra pills if there are any, such as bringing them to “take back events.”
Additionally, the survey looked at antibiotic use without a prescription and revealed that 19% of respondents reported taking antibiotics without talking to a health care professional — 17% took their own leftovers and 3% took someone else’s. Among those who reported having and keeping leftover antibiotics, 51% said they have taken them without talking to a health care professional.
Overall, Malani believes antibiotic misuse is a problem that can be fixed through the education of patients, family members and prescribers.
“Antibiotics are not without risks, so it's important that they are used properly,” she said. “The majority of patients did recognize that there are risks associated with antibiotic use and that overuse can contribute to antibiotic resistance — ‘not working as well’ — yet there is still a perception that if you are sick enough to go to the doctor, you expect a prescription.”
The survey also showed that 92% of older adults believe they are cautious about the use of antibiotics and 89% agreed that overuse can lead to weakened efficacy. Additionally, 56% believed that doctors overprescribe antibiotics. However, 41% felt that if they had a cold that lasted long enough for a doctor appointment, they would expect an antibiotic prescription and 34% believed antibiotics would help them feel better whether they had a cold or influenza. Almost one-quarter think doctors do not prescribe antibiotics when they should.
“With about half of older adults getting an antibiotic prescription during an average year, this is a lot of extra doses that could be used without clinical supervision, leading to serious side effects, drug interactions, and contributing to antibiotic resistance more broadly,” Malani said. “Take back events can be highlighted to patients with reminders about why they shouldn't take medications without supervision, especially antibiotics. As always, ongoing efforts [should be made] to educate the public about what antibiotics do and don't do — ie, not helpful for viral infections.” – by Caitlyn Stulpin
Reference:
National Poll on Healthy Aging. Antibiotic use and concerns. https://www.healthyagingpoll.org/report/antibiotic-use-concerns. Accessed November 21, 2019.
Disclosure: Malani is a member of the National Poll on Healthy Aging team.