Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.
Antimicrob Agents Chemother. 2024 Aug 7;68(8):e0046924. doi: 10.1128/aac.00469-24. Epub 2024 Jul 8.
Taking leftover prescribed antibiotics without consulting a healthcare professional is problematic for the efficacy, safety, and antibiotic stewardship. We conducted a cross-sectional survey of adult patients in English and Spanish between January 2020 and June 2021 in six safety-net primary care clinics and two private emergency departments. We assessed the reasons for stopping prescribed antibiotics early and what was done with the leftover antibiotics. Additionally, we determined 1) prior leftover antibiotic use, 2) intention for future use of leftover antibiotics, and 3) sociodemographic factors. Of 564 survey respondents (median age of 51), 45% (251/564) reported a history of stopping antibiotics early, with 171/409 (42%) from safety net and 80/155 (52%) from the private clinics. The most common reason for stopping prescribed antibiotics early was "because you felt better" (194/251, 77%). Among survey participants, prior use of leftover antibiotics was reported by 149/564 (26%) and intention for future use of leftover antibiotics was reported by 284/564 (51%). In addition, higher education was associated with a higher likelihood of prior leftover use. Intention for future use of leftover antibiotics was more likely for those with transportation or language barriers to medical care and less likely for respondents with private insurance. Stopping prescribed antibiotics early was mostly ascribed to feeling better, and saving remaining antibiotics for future use was commonly reported. To curb nonprescription antibiotic use, all facets of the leftover antibiotic use continuum, from overprescribing to hoarding, need to be addressed.
未经医疗专业人员咨询而服用剩余的处方抗生素，会对疗效、安全性和抗生素管理产生问题。我们在 2020 年 1 月至 2021 年 6 月期间，在六家医疗保障初级保健诊所和两家私人急诊部门，以英语和西班牙语对成年患者进行了横断面调查。我们评估了提前停止服用处方抗生素的原因以及剩余抗生素的处理方式。此外，我们还确定了 1）之前是否使用过剩余抗生素，2）未来是否打算使用剩余抗生素，以及 3）社会人口学因素。在 564 名调查对象中（中位数年龄为 51 岁），45%（251/564）报告称有提前停止服用抗生素的经历，其中 171/409 人（来自医疗保障诊所，占 52%）和 80/155 人（来自私人诊所，占 48%）。提前停止服用处方抗生素的最常见原因是“因为你感觉好多了”（194/251，占 77%）。在调查参与者中，有 149/564 人（26%）报告曾使用过剩余抗生素，284/564 人（51%）报告未来打算使用剩余抗生素。此外，较高的教育水平与更有可能使用剩余抗生素有关。对于那些就医存在交通或语言障碍的人来说，未来使用剩余抗生素的可能性更大，而对于有私人保险的人来说，则不太可能。提前停止服用处方抗生素主要归因于感觉好转，并且普遍报告说会将剩余的抗生素留作以后使用。为了遏制非处方抗生素的使用，需要解决从过度处方到囤积抗生素的剩余抗生素使用全过程的各个方面。
