Free antibiotics: The wrong prescription for cold and flu season

Free flu shots are a better option

17 jan 2009--With an epidemic of antibiotic-resistant infections growing, experts are warning grocery-store pharmacies that antibiotics giveaways are an unhealthy promotional gimmick. If grocery stores want to help customers and save them money during cold and flu season, the Infectious Diseases Society of America (IDSA) says, they should offer free influenza vaccinations instead.

Giant, Stop & Shop, and other grocery stores have recently begun offering free antibiotics at their pharmacies. Most concerning are promotions such as Wegmans' that link antibiotics to the winter cold-and-flu season—despite the fact that antibiotics will have no effect on these viral illnesses and carry risks of serious side effects.

"While it may make good marketing sense, promoting antibiotics at a time when we are facing a crisis of antibiotic resistance does not make good public health sense," said IDSA President Anne Gershon, MD. "On the other hand, grocery stores would be doing a tremendous service if they help more people get their flu shots."

A new study in the February 1 issue of Clinical Infectious Diseases shows that workers age 50-64 who received influenza vaccine lost substantially fewer days of work and worked fewer days while ill. But influenza vaccine is underutilized. Millions of doses were thrown away at the end of the last two flu seasons.

"The opposite is true for antibiotics," said Lauri Hicks, DO, medical director for the "Get Smart: Know When Antibiotics Work" program at the Centers for Disease Control and Prevention (CDC). "Each year tens of millions of antibiotics are prescribed for viral conditions, like the common cold, for which antibiotics are totally ineffective. Overuse of antibiotics is jeopardizing the effectiveness of these essential drugs."

For example, in some parts of the country methicillin-resistant Staphylococcus aureus (MRSA) is the leading cause of emergency room visits for skin and soft tissue infections. To make matters worse, there are very few new antibiotics under development to fight resistant bacteria.

In addition, the risks associated with antibiotics are under-appreciated. Allergic reactions and other adverse events cause an estimated 142,000 emergency room visits annually, according to a recent study by CDC.

"Most doctors know better than to prescribe antibiotics when they are not needed," Dr. Gershon added. "But many find it hard to say 'no' to sick patients who think antibiotics will make them feel better. We are concerned that these pharmacy marketing efforts will encourage patients to ask for antibiotics prescriptions."

IDSA urges grocery store pharmacies to partner with the CDC's "Get Smart" program. CDC and its partners educate the public and health care providers about when antibiotics will and won't work and the dangers of antibiotic resistance. For more information, see the Get Smart website.

"Lowering customers' health care costs is an admirable goal," Dr. Gershon said. "But singling out antibiotics for promotion when we are facing a crisis of antibiotic resistance is the wrong way to do it. On the other hand, free influenza vaccinations could make a real contribution to public health."

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The Infectious Diseases Society of America (IDSA) is an organization of physicians, scientists, and other health care professionals dedicated to promoting health through excellence in infectious diseases research, education, prevention, and patient care. The Society, which has more than 8,600 members, was founded in 1963 and is based in Arlington, VA. For more information, visit www.idsociety.org.