Prior nonprescription antibiotic use predicts similar use in future
Click Here to Manage Email Alerts
Key takeaways:
- In a survey, 43% of respondents reported nonprescription antibiotic use, 16% within the last year.
- Patients who reported nonprescription antibiotic use were likely to do so again in the future.
SEATTLE — Prior nonprescription antibiotic use within the last year predicted similar use in the future, according to data presented at the Society for Healthcare Epidemiology of America Spring Conference.
“We are interested in understanding factors that surround the practice of using antibiotics without a prescription from a doctor or health care practitioner,” Eva Amenta, MD, an infectious disease fellow at Baylor College of Medicine, told Healio.
“This can include using antibiotics that are left over from a prior prescription, getting antibiotics from friends or family, or obtaining antibiotics from abroad that are over the counter and without a prescription from a health care provider,” she said.
According to Amenta, using antibiotics without a prescription can have negative impacts, including side effects from the medications, interactions between the antibiotic and other medications the patient may be taking and a risk of additional infections, as well as a risk of increasing antibiotic resistance.
“One particularly important challenge is trying to identify people that might be at risk for using antibiotics without a prescription so we can provide important education about the risks and provide important alternatives,” Amenta said.
To test if screening patients for prior nonprescription antibiotic use in the past 12 months predicted their intentions to use them in the future, Amenta and colleagues surveyed 564 patients in the waiting rooms of six public clinics and two private EDs about prior and intended nonprescription antibiotic use between January 2020 and June 2021.
Using the question “Would you use antibiotics without contacting a doctor/nurse/dentist,” the researchers calculated the sensitivity, specificity and positive predictive value and negative predictive value of prior nonprescription antibiotic use in the past 12 months for future intended nonprescription use.
Overall, prior nonprescription antibiotic use was reported by 43% of survey respondents, with 16% reporting nonprescription use within the last 12 months.
According to the study, the sensitivity of prior nonprescription use in the past 12 months to predict the intention to use nonprescription antibiotics in the future was 75.9% (95% CI, 65.3%-84.6%), whereas the specificity was 91.4% (95% CI, 87.8%-94.2%).
Additionally, the positive predictive value of prior use to predict future intention was 74.5% (95% CI, 66.7%-80.9%), whereas the negative predictive value was 92% (95% CI, 88.7%-94.4%).
Amenta explained that these findings demonstrated that if a patient used antibiotics without a prescription in the last year, they were likely to intend to use antibiotics without a prescription in the future, whereas if a person had not used antibiotics without a prescription in the past year, they were very unlikely to use antibiotics without a prescription in the future.
“This is a low-cost, easy tool to help busy clinicians focus their educational efforts on patients at risk for using antibiotics without a prescription,” Amenta said. “By asking patients one question — if they used antibiotics without a prescription within the past year — doctors and health care practitioners can make the most impact in educating those who are most likely to intend to use antibiotics without a prescription in the future.”
Collapse
Amenta E, et al. Identifying non-prescription antibiotic users with screening questions in a primary care setting. Presented at: Society for Healthcare Epidemiology of America Spring Meeting; April 11-14, 2023; Seattle.
Read more about
Click Here to Manage Email Alerts