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The insane practice of hoarding antibiotics - (8/13/2019)

By Dr. Ron Gasbarro

The technician handed the pharmacist a prescription that had just appeared in the pharmacy’s inbox. It was for an antibiotic. No surprise there. But, the script also was written for 5 refills. “Do you want me to fill this the way it was written?” asked the tech. “Antibiotics don’t get that many refills.” The pharmacist said he would call the prescriber for an explanation. Multiple refills for an antibiotic are just one reason why we are facing the threat of an infectious disease pandemic that no existing antibiotic will stop.

The pharmacist called the doctor who wrote the prescription and asked about the refills. “Well, I wrote it for the mom but she has 3 kids too,” the doctor explained. “They are going away for the season and she said it would be easier to have the pills accessible should any or all of the boys get a cold.” “But what about resistance to antibiotics?” the pharmacist asked. “The patient insisted,” replied the doctor. “And if I don’t give them to her, she will get them somewhere else.”

First, viruses cause “colds” and antibiotics do nothing to cure them. Second, bacteria are becoming increasingly impervious to antibiotic treatment, which means the bacteria can mutate into dangerous strains. Third, there is the possibility that the entire population of the planet is at risk. Think it can’t happen? Throughout civilization, innumerable instances of widespread illness occurred that had devastating effects on populations. The Bubonic Plague – also known as The Black Death – took place in the 14th century, killing a third of the European population. Some historians believe that society subsequently became more violent as the mass mortality rate cheapened life and thus increased warfare, crime, and persecution. The 1918 Spanish Flu infected nearly one third of the world's population. Some estimates put the total deaths caused by this influenza pandemic as high as 100 million or around 5% of the human population at the time. 

While we have not experienced a biologic SHTF scenario as cataclysmic as those seen in the past, this does not mean one is impossible. The Centers for Disease Control and Prevention (CDC) states on its website, "While we can't predict exactly when or where the next epidemic or pandemic will begin, we know one is coming."

Surprise! We will create a new plague all by ourselves. A 2019 study showed that 66% of people obtain antibiotics without a prescription. And 48% of people in the study squirreled away antibiotics for future use. People got antibiotics through a wide variety of sources, including leftover prescriptions and often foreign local markets that sell antibiotics as over-the-counter medications. Other sources were family and friends, flea markets, pet stores, health food stores, and online venues. The study revealed that the reasons people self-treated with antibiotics included poor health-care access, long wait times at the doctor's office, costs of antibiotics and doctor visits, lack of transportation and embarrassment about getting treatment for sexually transmitted infections. 

From a safety standpoint, the antibiotics obtained from dubious sources could be outdated, counterfeit, or the wrong drug for the bacterial infection in question. One could argue that if one gets a prescription for an antibiotic and it is filled at a respectable pharmacy, then one should be ok. But that means the person, not the doctor, is the decider-in-chief when triaging a suspected bacterial infection. Danger! Danger! Will Robinson! 

In the US, 2 million people develop antibiotic-resistant infections each year, and 23,000 die from those infections, according to the CDC. The pharmacist told the doctor that he could not fill the script the way he wrote it. “It’s unethical.” The patient will not be happy but humanity will breathe a tiny sigh of relief. 

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com. Read more at www.rx-press.com

 


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