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Objectives <p>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.</p> Methods <p>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, “<i>would you use antibiotics without contacting a doctor/nurse/dentist/clinic</i>.” 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.</p> Results <p>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).</p> Conclusions <p>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.</p>

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A screening question to assess risk of using antibiotics without a prescription: a diagnostic study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月15日

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  • Ashley Collazo,
  • Eva Amenta,
  • Kiara Olmeda,
  • Marissa Valentine-King,
  • Lindsey Laytner,
  • Azalia Mancera,
  • Roger Zoorob,
  • Michael K. Paasche-Orlow,
  • Richard L. Street Jr,
  • Barbara W. Trautner,
  • Larissa Grigoryan

摘要

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.