Free antibiotics: The wrong prescription for cold and flu season

January 16, 2009

With an epidemic of antibiotic-resistant infections growing, experts are warning grocery-store pharmacies that antibiotics giveaways are an unhealthy promotional gimmick. If grocery stores want to help customers and save them money during cold and flu season, the Infectious Diseases Society of America (IDSA) says, they should offer free influenza vaccinations instead.

Giant, Stop & Shop, and other grocery stores have recently begun offering free antibiotics at their pharmacies. Most concerning are promotions such as Wegmans' that link antibiotics to the winter cold-and-flu season—despite the fact that antibiotics will have no effect on these viral illnesses and carry risks of serious side effects.

"While it may make good marketing sense, promoting antibiotics at a time when we are facing a crisis of antibiotic resistance does not make good public health sense," said IDSA President Anne Gershon, MD. "On the other hand, grocery stores would be doing a tremendous service if they help more people get their flu shots."

A new study in the February 1 issue of Clinical Infectious Diseases shows that workers age 50-64 who received influenza vaccine lost substantially fewer days of work and worked fewer days while ill. But influenza vaccine is underutilized. Millions of doses were thrown away at the end of the last two flu seasons.

"The opposite is true for antibiotics," said Lauri Hicks, DO, medical director for the "Get Smart: Know When Antibiotics Work" program at the Centers for Disease Control and Prevention (CDC). "Each year tens of millions of antibiotics are prescribed for viral conditions, like the common cold, for which antibiotics are totally ineffective. Overuse of antibiotics is jeopardizing the effectiveness of these essential drugs."

For example, in some parts of the country methicillin-resistant Staphylococcus aureus (MRSA) is the leading cause of emergency room visits for skin and soft tissue infections. To make matters worse, there are very few new antibiotics under development to fight resistant bacteria.

In addition, the risks associated with antibiotics are under-appreciated. Allergic reactions and other adverse events cause an estimated 142,000 emergency room visits annually, according to a recent study by CDC.

"Most doctors know better than to prescribe antibiotics when they are not needed," Dr. Gershon added. "But many find it hard to say 'no' to sick patients who think antibiotics will make them feel better. We are concerned that these pharmacy marketing efforts will encourage patients to ask for antibiotics prescriptions."

IDSA urges grocery store pharmacies to partner with the CDC's "Get Smart" program. CDC and its partners educate the public and health care providers about when antibiotics will and won't work and the dangers of antibiotic resistance. For more information, see the Get Smart website.

"Lowering customers' health care costs is an admirable goal," Dr. Gershon said. "But singling out antibiotics for promotion when we are facing a crisis of antibiotic resistance is the wrong way to do it. On the other hand, free influenza vaccinations could make a real contribution to public health."

Source: Infectious Diseases Society of America

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5 comments

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tpb
1 / 5 (2) Jan 16, 2009
Antibiotic resistance from giving antibiotics so someone without a bacterial infection is a theory.

No studies have proven the hypothesis that antibiotics given to someone who doesn't have a bacterial infection causes antibiotic resistance.

It's far more likely that the problem is caused by hospitals not giving their bacterial infected patients enough of several different antibiotics, for a long enough time to ensure that the infection is eradicated.

Livestock who are given low levels of antibiotics for their entire lives are healthier. This shows the antibitics are working without the bacteria developing resistance.

How is this possible when presumably giving someone an atibiotic for a week for an infection they don't have is supposed to produce antibiotic resistance.

This doesn't pass the common sense test.

For those who are going to jump all over me for this, many medical theories have been repeated over and over, until believed by everyone because they seem plausible, only to be proven nonsense.
barakn
2 / 5 (4) Jan 17, 2009
Tpb,

Since all humans are "infected" with normal flora (neutral or helpful bacteria) and because resistance genes can be passed from one type of bacteria to another via a process known as horizontal gene transfer, your "common sense" is nonsense.

As for antibiotics in cattle, according to cattletoday.com (http://www.cattle....shtml): "The low level antibiotics in feed is hardly an issue, since the drugs used in feed (rumensin, bovatec, neomycins, etc.) are not used in humans at all or rarely used." As a matter of fact, since the level of antibiotic given is often not enough to kill bacteria, the mechanism by which the use of such antibiotics causes increased weight gain in livestock is unclear. Without levels too low to kill bacteria, it is hard to imagine why bacterial resistance would emerge. The real problem is when livestock do get sick and they are given much higher levels of antibiotics, including antibiotics that are used by humans.
jonnyboy
not rated yet Jan 17, 2009
tpb,

The numberous high- quality studies showing increased resistance to antibiotics are too numerous to mention. You apparently have access to the Internet but don't use it to educate your self on the facts.

Your "COMMON SENSE" is NONSENSE !!!!!!!!!!
denijane
not rated yet Jan 18, 2009
barakn and jonnyboy,
could you please give me a link to a study proving that taking antibiotics before you develop a bacterial infection lead to resistance of a bacteria?

I don't care about common sense, I'd like to read a study proving that your intestinal flora can pass a resistant gene to another bacteria that has nothing to do with it and probably would never come in contact with it since we're mostly talking about pulmonary diseases here.

To me, it makes much more sense that the resistance is merely a statistical result from the massive use of antibiotics-prescribed or not. It's just the way things happen in Nature-if it wasn't like this, we would never be here. It's called evolution. And our major problem is that instead of evolving, we're killing off all the bacteria around us, so when something invade us, the only option we have is to take an antibiotic.
tpb
not rated yet Jan 19, 2009
To barakn, please show me a study that proves horizontal gene transfer occurs in humans, say from ecoli to MSRA.
To jonnyboy, you obviously don't understand evolution, resistance can only develop when the bacteria isn't killed by the antibiotic.
I've not said that resistance doesn't occur.
The fact that the resistant MSRP bacteria are endemic in hopitals and not in the general population, indicates that the problem is more likely to be insufficient treatment in the hospitals, and has nothing to do with giving antibiotics to people who don't have bacterial infections..

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