URTI Self-Diagnosis May Aggravate Antibiotic Misuse

Self-diagnosis of upper respiratory tract infections (URTIs) may be contributing to the rise of antimicrobial resistance.

Researchers from Curtin University in Australia examined 123 patients from 19 pharmacies in a recent study. The participants completed a survey in which they self-reported repeat antibiotic prescriptions, including those used to treat URTIs.

The questionnaire was separated into 2 sections. First, participants were asked about demographics and the frequency and nature of their prescription medication use. Second, pharmacists answered questions about the participants’ presentation, concessional status, the date of original prescriptions, whether the prescription was computer-generated or handwritten, the antibiotic name and dosage form, the number of repeats allowed and the number remaining, and the zip code of the pharmacy.

The researchers discovered that about one-third of the participants arrived at the pharmacy to fill a repeat antibiotic prescription at least 1 month after their physician wrote the original prescription.

Two-thirds of them did not consult their physician before going to the pharmacy to have their repeat prescription dispensed.

Reasons for this ranged from “the doctor told them to take the second course,” to self-diagnosis, to continued symptoms.

The most common reason for the antibiotic repeats was cough symptoms. Other reasons included not feeling better after the first course, earache, sore throat, blocked nose, runny nose, and “starting to get sick and not wanting it to get worse.”

One-third of the participants said their physician did not tell them what the repeat prescription was for. Interestingly, patients who had repeat antibiotic prescriptions filled more than 2 weeks after the original prescription was written were more likely to not consult their physician and not know why the repeat antibiotic course was required.

“This study suggested that the current 12-month validity of antibiotics repeat prescriptions is potentially contributing to patients’ self-diagnosis of URTIs and therefore potential misuse of antibiotics,” the authors concluded, noting that further research is necessary to confirm these findings. “This may be contributing to the rise of antimicrobial resistance.”

As far as the prescriptions themselves, the majority was computer-generated (82.6%) and the most common antibiotic prescribed was amoxicillin with clavulanic acid (40.4%), followed by amoxicillin alone (21.2%). Most of the prescriptions (88%) were written with 1 repeat.

These study findings were published in the Journal of Pharmaceutical Policy and Practice.