No one would argue that antibiotics are an amazing 20th-century innovation, promising a quick cure for bacterial illnesses that might otherwise cause serious harm or death.
But they are not without risk, especially when taken without a doctor's supervision.
Yet a new study review suggests that's exactly what many Americans are doing: misusing "under-the-counter" or old leftover antibiotics to self-medicate without seeing a doctor or getting a prescription.
"There are clearly all kinds of ways people can get antibiotics without seeing a doctor," noted study lead author Dr. Larissa Grigoryan. She's an assistant professor of family medicine at Baylor College of Medicine in Houston.
Some patients store leftovers from prior valid prescriptions. Others obtain them from family or friends. Still, others source them online, or at flea markets, health food stores, and even pet shops.
"And for all kinds of reasons it can be very tempting for people to get them one of those ways, rather than see a physician," Grigoryan said.
After reviewing 31 prior studies conducted between 2000 and early 2019, Grigoryan and her colleagues concluded that there is no one explanation or pattern driving antibiotic misuse.
Sometimes drug cost is the main factor. Sometimes it's a lack of insurance, or not wanting to miss work to see a doctor. Other patients simply want to avoid the hassle, Grigoryan added, "because they mistakenly think that antibiotics are no big deal and don't need supervision."
One investigation indicated that among patients seeking care at a medical clinic just 1% said they used antibiotics without prescription. But another study found that two-thirds of Hispanic migrant workers embrace the practice, with other groups falling somewhere in between.
One study observed that about 14% of Americans store old antibiotics for future use. Others indicated that the habit is much more common, with one concluding that nearly half the country keeps leftovers. Still, another suggested that a quarter of patients are fine with using antibiotics without a prescription.
"But the main message for anyone who does so is the same for everyone," Grigoryan said. "Taking antibiotics without a current doctor's prescription and supervision is unsafe."