Language
English
Publication Date
4-15-2025
Journal
BMC Primary Care
DOI
10.1186/s12875-025-02811-3
PMID
40234795
PMCID
PMC11998457
PubMedCentral® Posted Date
4-15-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Objectives: Non-prescription antibiotic use (using antibiotics without medical advice) is potentially unsafe and promotes antimicrobial resistance. We studied predictors of prior non-prescription use and whether screening for prior non-prescription antibiotic use predicted intention of future non-prescription antibiotic use.
Methods: The survey was performed from January 2020 - June 2021 in six public primary care clinics and two private emergency departments. Prior non-prescription users were respondents who reported taking oral antibiotics for symptoms without contacting a clinician. Intended use was defined by answering yes to the question, "would you use antibiotics without contacting a doctor/nurse/dentist/clinic." We examined predictors for prior non-prescription use. We also calculated the sensitivity, specificity, and positive and negative predictive value (PPV, NPV) of (a) any prior non-prescription antibiotic use and (b) prior use in the past 12 months - for future intended non-prescription use.
Results: Of 564 survey respondents, 246 (43.6%) reported non-prescription use; 91 (37.0%) of these respondents, 16.1% overall, reported doing so in the past 12 months. Approximately 63% of non-prescription antibiotic use was in those with a previous prescription of the same antibiotic for similar symptoms/illnesses. The screening characteristics of non-prescription use in the past 12 months to identify intention to use of antibiotics without a prescription in the future were: sensitivity 75.9% (95% CI: 65.3-84.6), specificity 91.4% (95% CI: 87.8-94.2), Bayes' PPV 74.5% (95% CI: 66.7-80.9), and Bayes' NPV 93.7% (95% CI: 90.5-96.1).
Conclusions: This study proposed a method to screen for future use of non-prescription antibiotics, which may have implications on antimicrobial stewardship efforts in primary care settings.
Keywords
Humans, Anti-Bacterial Agents, Female, Male, Middle Aged, Adult, Surveys and Questionnaires, Primary Health Care, Risk Assessment, Nonprescription Drugs, Aged, Antibiotic stewardship, Primary health care, Bacterial drug resistance, Anti-bacterial agents, Predictive value of tests
Published Open-Access
yes
Recommended Citation
Collazo, Ashley; Amenta, Eva; Olmeda, Kiara; et al., "A Screening Question To Assess Risk of Using Antibiotics Without a Prescription: A Diagnostic Study" (2025). Faculty and Staff Publications. 3937.
https://digitalcommons.library.tmc.edu/baylor_docs/3937