Why can’t antibiotics be purchased over-the-counter in the United States?
Antibiotics sometimes seem like miracle drugs the way they help cure
diseases.
A huge number of antibiotics are available via prescription for persons to take.
But none are available over-the-counter.
I support making at least one common antibiotic purchasable without a
prescription. This may improve persons' access to healthcare while decreasing
costs.
The United States arguably has the finest health care system in the world at its best, yet
many cannot afford treatment. Millions either lack insurance, lack the ability
to pay deductibles, or their insurance claims are denied. Office visits and
prescriptions cost a lot.
In some cases self diagnosis can help save money, time, and improve medical
treatment. Responsible medical websites like WebMD and MayoClinic provide
quality information that in some cases enable persons to come closer to
diagnosing their own problems, although such sites make it clear they are not a
substitute for professional personal medical advice and they are not intended
for diagnosis or treatment. Indeed, many medical professionals turn to online
information to help with their diagnoses.
While office visits and examinations by a medical professional can be
productive, they can also be very expensive. And often the main thing a
physician does is prescribe an antibiotic for a condition the patient has—a
condition the patient may already suspect they have due to past experience,
viewing online medical websites, etc.
I support making at least one or two commonly prescribed antibiotics available
without a prescription. For example, amoxicillin has been around for decades and
is one of the most commonly prescribed antibiotics. Why not make amoxicillin
available without a prescription for a start?
Risks From Making Antibiotics Over-the-Counter
Perhaps the biggest risk of making antibiotics available over-the-counter is the
risk of overuse. Persons may seek to take an antibiotic for a virus or something
else that antibiotics are not effective against.
Indeed, physicians sometimes overprescribe antibiotics now, perhaps just to be
extra cautious in case they misdiagnosed a virus. Furthermore, misusing
antibiotics is reported to lead to the development of “superbugs” that are
resistant to many antibiotics.
The Centers for Disease Control and Prevention website reports (See endnote
1)
that “Each year in the U.S., at least 2.8 million people get an
antibiotic-resistant infection, and more than 35,000 people die.” Misuse of
antibiotics likely contributes to this.
But I feel the benefits of providing a common antibiotic without a prescription
outweigh the risks, even if the particular antibiotic(s) made available
over-the-counter are not suitable for all purposes.
Also, if only one or two antibiotics are made available without a prescription,
it still reserves a huge number that physicians can use their discretion in
prescribing.
While persons may misuse over-the-counter antibiotics, individuals already abuse
tobacco, alcoholic beverages, and numerous over-the-counter medications. These
can be far riskier than a common antibiotic, especially if persons take
appropriate dosages of the antibiotic only when necessary.
Many Over-the-Counter Medications and Dietary Supplements Exist
A large number of medications and dietary supplements are available
over-the-counter, including those pictured below that I own. But prescription
medicines are not.
Precedent for Making Prescription Drugs Over-the-Counter
There is a precedent for medicines to progress from being available only via
prescription to being available over-the-counter. For example, my mom told me
that many years ago when I was a boy a doctor prescribed Benadryl for an
allergic reaction I had. Since then, Benadyl has been made available
over-the-counter. For many years now Benadryl has been available
over-the-counter and benefits huge numbers of allergy sufferers without the need
for or expense of an office visit and prescription.
The article (See endnote 2)"Prescription to over-the-counter switches in the
United States” in the Journal of Research in Pharmacy Practice, viewable on the
journal website and the website of the National Center for Biotechnical
Information, discusses these conversions, as well as some of the benefits,
potential problems, etc.
Current Situation and Recommendations
Some persons in the United States already take antibiotics without a
prescription. They ingest leftover medicine from a previous prescription or use
medicine from another person’s prescription. They also may buy antibiotics
online from a website that may or may not be reputable and may or may not offer
genuine products that are packaged, stored, and shipped safely.
I'm not a medical professional and can't give any medical advice. Many medical
professionals who know far more about antibiotics and medical care than I are
opposed to making antibiotics available without a prescription.
Still, I strongly support the U.S. Food and Drug Administration either taking
action to make some common antibiotic available over-the-counter or clearly
stating why it opposes doing so. And I urge readers to prayerfully consider
urging the Food and Drug Administration (and/or Congress) to act to make some
type of common antibiotic available for purchase over-the-counter rather than
via prescription.
Endnotes:
1 “Antibiotic/Antimicrobial Resistance (AR/AMR)”; Centers for Disease Control
and Prevention; page last reviewed July 20, 2020
https://www.cdc.gov/drugresistance/index.html webpage accessed July 21, 2021
2 Chang, Jongwha; Lizer, Allison; Patel, Isha; Bhatia, Deepak; Tan, Xi; and
Balkrishnan, Rajesh; “Prescription to over-the-counter switches in the United
States”; Journal of Research in Pharmacy Practice; 2016-July-September; 5 (3):
149-154;
https://www.jrpp.net/downloadpdf.asp?issn=2319-9644;year=2016;volume=5;issue=3;spage=149;epage=154;aulast=Chang;type=2
webpage accessed July 21, 2021
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