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Why not make antibiotics over the counter?

Dana Corriel, MD
Meds
June 27, 2016
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Bacteria are rapidly becoming resistant in our antibiotic-loving society. This statement is a fact. We are facing a threat not only to our country, but to the world.

I have a proposal to make: over-the-counter antibiotics.

(Insert tongue-in-cheek here.)

Will this help us deal with the falsely popular notion that antibiotics are a cure-all? I don’t know, but here’s something I do. I’ve had patients storm out because I’ve said no, and I take the chance of a negative review right then and there when it happens. Not to mention a lawsuit, should some complication arise, and a lawyer takes on the case of “why weren’t antibiotics prescribed.”

Should we basically cater to patient requests? We take a risk when we say no, in this increasingly customer-service based field, so why not just have them over-the-counter?

We’ve all seen the relevant cartoon. It’s posted on my personal Facebook page, sent by a good friend just the other day. A mug, held by the hand of a doctor, states, “Don’t confuse my medical degree with your Google search.” Sigh. If this were only a joke.

I have had several interactions in the office where a patient, after saying hello and being asked the common office conversation starter, “Why are you here today?” answers with, “I’m here to get a Z-pak for my bronchitis.”

Basically, the patient here makes an appointment to let me know what he’s got. And let’s face it, my patient wants one thing, and one thing only, an antibiotic prescription. I do get it on one hand, it’s 2016, and there’s an internet with sites like Wikipedia and WebMD, where you can look up any symptom and essentially choose what you have from the list.

I also get that doctors over the years have been prescribing Z-paks like Band-Aids, for every cough, sore throat, or airway issue that walks through that door. Combine the two and we’re growing into a generation of self-diagnosing, misinformed alarmists.

And now, we are sadly reaching a crisis in antibiotic over-prescription as the threat of superbugs in this world grows, and resistance develops in response to overuse. It is up to health care professionals, like you and I, to put an end to common misuse and misconceptions of those who simply refuse to understand. I know it’s often easier to just cave, and throw that antibiotic at our patient, and it probably saves us time and aggravation. Not to mention a decrease in liability if, heaven forbid, you were to actually miss.

Why not prescribe an antibiotic, just in case, you ask. Many of them change our gut flora to wipe out some of the necessary bacteria that live there, helping us with normal digestion. This, in turn, causes abdominal discomfort, nausea, loose stools. Then there are more serious effects like heart rhythm disturbances and neurological phenomonon. Just a week ago, the FDA came out with heavier warnings regarding a class of drugs readily prescribed for common ailments such as urinary tract infections and respiratory tract infections, citing serious adverse reactions were more frequent than previously believed.

So to the patient who comes in having already diagnosed himself, or having decided which medicine the doctor should prescribe, nothing is more irritating than a doctor who disagrees. Usually, your mind is already made up, and you know just what you want.

My proposal stands. Why not just have them there, behind the counter, ready for pick up at the local pharmacy? Or ordered delivery-service-style? Let’s face it, we’ll all save the trouble. Less missed work, less wait time, less aggravation. And best of all, the doctor gets great marks on his next social media mention.

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Dana Corriel is an internal medicine physician who blogs at drcorriel.

Image credit: Shutterstock.com

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Why not make antibiotics over the counter?
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