The Impact of Over-the-Counter Antibiotics on Resistance Rates
Antibiotics are essential lifesavers of modern medicine, used to combat all sorts of bacterial infections. According to the World Health Organization (WHO), the effectiveness of antibiotics is threatened by rising antimicrobial resistance (AMR). In some areas of the world, antibiotics are available without a prescription, which can result in severe suboptimal use of antibiotics and have a huge impact on public health, as it can lead to higher resistance rates and complicate treatment. Here’s how over-the-counter antibiotics can lead to resistance, and what can be done.
Antibiotics are freely available in many parts of the world without prescription – a convenience that leads to their widespread overuse or misuse, which can fuel the emergence of antibiotic-resistant bacteria. Using antibiotics when they’re not needed, or when they’re taken in sub-optimal – too high, too low – concentrations can encourage bacteria to evolve to survive those drugs. This is more than just fear mongering. The high use and access to antibiotics without a prescription is frequently associated with elevated bacterial resistance, thus impacting disease management and increasing health costs.
One of the major issues with over-the-counter antibiotics is that they are often used without proper medical supervision. Consumers might not know the difference between bacterial and viral infections, and therefore take antibiotics when they are not needed. This misuse can lead to incomplete courses of treatment, where not all bacteria are eradicated and as a result the surviving bacteria develops resistance mechanisms, making future infections harder to treat.
Additionally, the sale of antibiotics without prescriptions can increase this threat by facilitating the spread of fake or poor quality medications, some of which might be sold in areas of loose regulation where quality controls are absent. According to the WHO, many substandard antibiotics will contain too little active ingredient to kill the bacteria entirely, promoting resistance.
The sale of antibiotics, which must also be regulated, is likewise important. Stricter prescription requirements that limit dispensing antibiotics to licensed healthcare providers are one option. In regions where strict prescription regulations for antibiotics override loose sale policies, resistance remains lower than in regions where the opposite is true. In Sweden and the Netherlands, for instance, where strict prescription regulations dictate which antibiotics drugs can be sold in pharmacies and with what prescription, overall resistance is lower than, say, in Italy, where stricter prescription policies coexist with loose sale guidelines.
Public education is another way to address antibiotic resistance. Raising awareness about the dangers of self-medicating with over the counter antibiotics, as well as about the importance of following the advice of medical professionals, can begin to move the needle on public behavior. Campaigns could also educate the public about how bacterial and viral diseases differ and what to expect if they receive antibiotics when they don’t need them. Effective communications strategies can empower consumers to make prudent decisions about seeking medical care and strengthen their relationship with and trust in their provider.
Furthermore, creating more robust healthcare infrastructure and access to medical care can reduce the reliance on over the counter antibiotics. Fortunately, access to healthcare professionals and diagnostic services can improve if healthcare facilities are built or upgraded. Most importantly, the misdiagnosis and use of self-medication can be reduced if people can see physicians and specialists.
In conclusion, the availability of antibiotics without prescription is a significant factor contributing to the rise in antimicrobial resistance. The fact that people in areas where regulations on antibiotics are not strongly enforced misuse and overuse the drugs that might cause those bacteria to develop resistance against the drugs makes it more difficult to treat bacterial infection and as a result it could be a threat to public health. To prevent and control the emergence of resistance, more measures are needed such as the regulation on the sale and prescription of antibiotics, public health education and improvement of the healthcare systems.
