番茄社区

ORLANDO -- Parents said they often saved leftover antibiotics and gave them to other people, both within and outside the family, according to researchers here.

In an anonymous online questionnaire distributed to a national sample of 496 parents through Amazon Mechanical Turk, nearly half (48.2%) of the parents reported that they'd kept leftover antibiotics rather than properly disposing of them, reported Ruth Milanaik, DO, of Cohen Children's Medical Center, Northwell Health in Lake Success, New York, and colleagues.

Of those, 73% said they subsequently diverted the medications to siblings, unrelated children, and unrelated adults, all without physician consultation. Parents also said they used the leftover antibiotics themselves, the authors stated in a presentation at the American Academy of Pediatrics (AAP) annual meeting.

"This is a dangerous practice," Milanaik said at an AAP press conference. "As we have gotten smarter about development of antibiotics, our microbes have gotten smarter as well. They have learned from every mistake we have ever made, and from every shortened course of antibiotics."

"We, as clinicians, need to do a better job of telling our patients that proper disposal of antibiotics is a really important practice," she added.

Milanaik said her group decided to look at instances of antibiotic diversion after observing the apparent inappropriate use of the medications during clinic visits.

"I would have children who come into the clinic with a rash, and I would ask the parent what they were doing to treat the rash. They would say 'Well, we had this cream that we used for Joan a few years ago, so we are using that.' And I asked 'Where did you get the cream?' and they would say 'From the fridge. We have had it a year, but it's still good, right?'"

The most common form of antibiotics diverted was liquids by 80.4% of parents whose children were prescribed them, followed by drops (73.8%) versus creams (69.7%) and tablets (55.6%), the authors reported.

Also, parents usually used medications in the dose that was originally prescribed, without consideration of changes or differences in age or weight, Milanaik noted.

Overall, 16% of participants stated that they had given their child adult medications.

Co-author Tamara Kahan said in a press statement that one of the parents gave for diverting antibiotics was the desire to avoid the costs involved with a second trip to the doctor.

"Follow-up surveys could examine whether there is a correlation between lack of access to health insurance or primary care and antibiotic diversion," Kahan noted in the statement.

Tom Wolynn, MD, of Kids Plus Pediatrics/Children's Hospital of Pittsburgh, told 番茄社区 that economics may play a role in why people don't throw out antibiotics properly.

"You paid for a visit, which may require a high co-pay, and then there is a co-pay for the medication, so some families who are struggling to make ends meet will have invested $100 or more into getting this medication...there is a reluctance to throw it out," said Wolynn, who was not involved in the study. "I see more and more people in my own practice who are struggling with costs, so my guess is that is part of the reason why they hold onto these medications."

"Clearly the danger is that it might be a different child, a different age, it might be a different diagnosis, it might be the wrong dose, and then there is the societal concern of creating antibiotic resistance," Wolynn stating, adding that the results are likely generalizable to a larger population.

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