NEW ORLEANS — A substantial number of people in the U.S. Hispanic community self-medicate with oral antibiotics, according to a study presented at the annual conference of the Society of Teachers of Family Medicine.
Many countries in Latin America dispense antibiotics without a prescription, and individuals from these countries have cultural norms for self-medication, said Arch G. Mainous III, Ph.D. The researchers interviewed 219 self-identified Hispanics, and 45% indicated they had purchased nonprescribed antibiotics outside the United States at some time; 16% had imported them. “Those results were striking,” said Dr. Mainous, professor of family medicine at the Medical University of South Carolina, Charleston. “Another striking feature was that 19% had acquired antibiotics not prescribed for the person in the United States; 93% [of them] said they got them in stores.”
Latin America has a high level of antibiotic resistance, Dr. Mainous said. U.S. interventions on resistance have decreased antibiotic prescribing, but they focus on prescribing. To correct inappropriate acquisition and use, patient education materials should not only be available in Spanish, but also should be culturally sensitive, he suggested.
The findings of the study, Dr. Mainous said, “point to a large unrecognized reservoir of nonprescribed antibiotics likely used for inappropriate self-medication. We know from other studies that people in countries where antibiotics are available tend to take subtherapeutic doses.”
Trained bilingual interviewers used a standard questionnaire to learn acquisition history and attitudes regarding nonprescribed antibiotics. All participants were 18 years and older and were recruited from one of two clinics in Charleston. The individuals were not necessarily patients, Dr. Mainous said.
The majority, 75%, indicated Mexico as their country of birth; 41% said they had been in the United States fewer than 4 years; and 90% did not have medical insurance.
The common cold, ear infections, cough, and sore throat were the primary illnesses for which respondents took nonprescribed antibiotics.
A large proportion (31%) of Hispanics surveyed thought antibiotics should be available over the counter, Dr. Mainous said. The belief that antibiotics should be available over the counter and past purchases outside the United States were highly related, he added.
Of interviewed individuals, 64% said they acquired antibiotics without a prescription because it was preferable to a physician visit. “Only 7% said there was a language barrier, so most did not want to spend the money or go to a doctor.”
Dr. Mainous pointed out that this phenomenon is not limited to Hispanics. “People in the Philippines, Taiwan, and Bangladesh will also buy subtherapeutic doses for self-medication.”