Thursday, April 23, 2009

Amoxicillin with your froot loops

I saw this Stop & Shop ad in Boston while doing my grocery shopping a few months ago. At first, I thought it was a joke: I mean, free antibiotics? After getting clarification from the pharmacist, the scheme is that if you bring in a prescription for an antibiotic, they will give you the generic version, for free. They'll decide on the course - up to 14 days for some antibiotics!

The problems with this, obviously, are tremendous. Not just being exposed to an antibiotic unnecessarily (and they all have side effects). Not just more vociferous demands on health care providers to give them an antibiotic prescription for their runny nose, with the knowledge that they'll be free. But mostly, and I haven't seen the data (and I doubt that I ever will), it's the likelihood that this will lead to an over-dispensation of antibiotics. Which is a very bad thing.

Antibiotic resistance is one of the gravest challenges facing our society over the next generation. They were the opening salvo of the modern medical revolution half-a-century ago, and are directly responsible for much of the healthcare gains that we've made as a society. Unfortunately, bacteria are smarter than we are, and coming up with new antibiotics proceeds at only a snail's pace.

While the new drug pipeline continues to flow, what's most important is that we try our hardest to keep our current armamentarium as active as possible, with judicious and intelligent usage, effective infection control of known resistant organisms, and improved santitation and hygiene in high-risk environments. Otherwise, it would be a scary world if we continue to see the spread of resistant bacteria without the drugs to treat them with.

The Lancet Infectious Diseases, . (2009). US supermarkets redefine antibiotic misuse The Lancet Infectious Diseases, 9 (5), 265-265 DOI: 10.1016/S1473-3099(09)70115-X

3 comments:

  1. Publix has done this for some time now. When I caught strep throat (about a year and a half ago), I received free antibiotics, which saved me a whopping $8, since I do have prescription coverage through my employer. To my knowledge, they still provide them.

    Before you ask, yes, I took the entire course of treatment.

    If you want to analyze the effect of no-cost availability of antibiotics on prescription rates, you could analyze Publix's market. I don't think the impact is likely to be significant, primarily because most MDs are wise enough not to give out antibiotics like candy.

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  3. Agreed, Benjamin, that likely this won't make a huge impact on antibiotic use. What I fear, however, is the public perception of antibiotics may change to something that can, in short, be gotten for free at the supermarket, instead of as the valuable and dangerous medications that they are.

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