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Parents frequently share children’s antibiotics with others
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ORLANDO, Fla. — Almost half of parents who had leftover antibiotics that were prescribed for their children stored them for later, and almost three-quarters of those parents subsequently shared the prescription with other children or adults. The practice is known as antibiotic diversion.
Researchers said the findings were “alarming” — not only from a safety standpoint but also because of the growing threat of antibiotic resistance.
“Patients should not be reusing antibiotics for any reason. They should throw them out the way they are supposed to be thrown out,” Ruth Milanaik, DO, associate professor at Hofstra Northwell School of Medicine, told Infectious Diseases in Children. “If you are given a course of antibiotics for 14 days, the doctor truly means that you should take the antibiotics for 14 days. There is reasoning behind that.”
Milanaik and colleagues conducted an anonymous survey of 550 parents whose children were prescribed antibiotics. Participants specified the formulation of the antibiotics — liquid, drops, cream or tablet — along with the people with whom they shared their children’s antibiotics and the dosage that was given. Parents were also asked if they had ever given a medication prescribed for an adult to their child.
Of the 454 parents who had leftover antibiotics, 48.2% reported saving them for later. Of these parents, 72.6% said they diverted the antibiotics. Antibiotics in liquid form were the most commonly diverted type (80.4%), researchers said, followed by drops (73.8%), creams (69.7%) and tablets (55.6%).
Findings also showed that antibiotics were most often diverted from children to their siblings or parents took the prescriptions for their own purposes. The diverted antibiotic was usually given at the prescribed dosage — even though it was meant for someone else — or the dosage was estimated based on a child’s weight or age.
Sixteen percent of parents admitted that they had given their children an antibiotic prescription that was meant for an adult. Most parents surveyed were women (85%) and Hispanic/Latino (69%).
Milanaik said parents frequently divert antibiotics for reasons they see as common sense.
“They may say, ‘I had a rash that was very similar to that,’ but they may be giving another person the entirely wrong medication,” she explained. “In this really crazy, busy world, we are all trying to save time. Maybe we don’t have time to take off and take your child to the doctor. The symptoms may seem similar and the medication isn’t all that old, but it is a really dangerous practice.”
Milanaik stressed the importance of finishing a course of antibiotics, because not doing so could encourage the development of antibiotic resistance.
“The problem with doing shortened courses is that we may simply be giving the bacteria something to learn from. You want to make sure that we are using the right antibiotics for the prescribed amount of time,” she said.
Milanaik said pediatricians need to do a better job advising parents on how to dispose of medication. The CDC and NIH have resources for how to properly dispose of antibiotics and other drugs, she noted. – by John Schoen
Reference:
Milanaik R, et al. Diversion of prescription antibiotics: Should you take from Peter to treat Paul? Presented at: AAP National Conference & Exhibition; Nov. 2-6, 2018; Orlando, Fla.
Disclosure: Milanaik reports no relevant financial disclosures.
Perspective
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Pamela Gigi Chawla, MD
There are a couple of really interesting things in this study for pediatricians to know. The first is that, 50% of the time, there are leftover antibiotics, and that tells me that patients are not taking their course of antibiotics, leaving them at risk for only partially treated infections and potentially creating antibiotic resistance problems in the future. Among those with leftover antibiotics, 70% are diverting antibiotics for use in other people. Most of the time, it is for the siblings or for the parents themselves, but we really need to council our families on what a dangerous practice that is. Those doses are being determined by families just based on what was prescribed for the child — and that leaves those kids and those parents at risk for being overdosed or underdosed, and therefore at risk for antibiotic resistance in the future.
Families may not understand that some antibiotics are related to other antibiotics and so risk allergies or serious consequences for those they are diverting the antibiotics to, as well.
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