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Survey Finds Alarming Percentage of Families Share Leftover Antibiotics

11/2/2018

AAP contacts: Laura Alessio, 630-626-6276 or lalessio@aap.org
                       Lisa Black, 630-626-6084 or lblack@aap.org

Research to be presented at American Academy of Pediatrics 2018 National Conference & Exhibition shows nearly three-quarters of parents who keep leftover antibiotics give them to others, raising risk of drug-resistant bacteria.

ORLANDO, FLA – Taking antibiotics when they're unnecessary, or in the wrong dose or timeframe, fuels rising rates of antibiotic-resistant infections. Suggesting a need to step-up efforts to raise awareness about this risk, results of a new survey found parents commonly saved leftover antibiotics and gave them to others within and outside the family.

An abstract of the study, "Diversion of Prescription Antibiotics: Should You Take from Peter to Treat Paul?" will be presented at the American Academy of Pediatrics (AAP) National Conference & Exhibition on Monday, Nov. 5, at the Orange County Convention Center in Orlando, Fla.

Senior author Ruth Milanaik, DO, FAAP, said they study results show an "alarming" percentage of parents in a national sample report sharing or borrowing antibiotics, a practice called prescription diversion.

"This is dangerous not only for those given antibiotics that weren't prescribed for them, but for entire populations of people who some antibiotics may no longer help when the bacteria they target become resistant to them," said Dr. Milaniak, who is Director of the Neonatal Neurodevelopment Follow-Up Program at the Cohen Children's Medical Center of New York.

For the study, an anonymous online questionnaire was distributed to a national sample of 496 parents though Amazon Mechanical Turk. Nearly half (48.2 percent) of the parents reported that they'd kept leftover antibiotics rather than properly disposing them. Of those, 73 percent subsequently diverted them to siblings, unrelated children, and unrelated adults—sometimes months after the antibiotic was originally prescribed--all without physician consultation. Parents also used the leftover antibiotics themselves.

Among other findings:

  • The most common form of antibiotics diverted was liquids (80.4 percent of parents whose children were prescribed them) and drops (73.8 percent), compared to creams (69.7 percent) and tablets (55.6 percent).

  • The dosage of antibiotic that was administered was typically the prescribed dosage, even though the recipient of the antibiotic had changed, or was estimated based on the age of the child.

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

Dr. Milanaik said more effort and resources need to be invested in educating families about how antibiotics work, that they aren't necessary for all illnesses, and the medical risks of taking antibiotics without consulting a health provider.

"Although the discovery of antibiotics has revolutionized medicine, it is imperative that clinicians emphasize the importance of use and dispose of these medications properly to make sure they remain an effective tool against infectious diseases," Dr. Milanaik said.

The goals of future research, the abstract's presenting author Tamara Kahan said, should include determining the most effective ways to communicate to parents the risks involved in antibiotic diversion, as well as pinpointing the circumstances in which antibiotic diversion is most likely to occur.

"For example, we found one of the common reason parents gave for diverting antibiotics was that they wanted to avoid the costs involved with a second trip to the doctor," Ms. Kahan said. "Follow-up surveys could examine whether there is a correlation between lack of access to health insurance or primary care and antibiotic diversion," she said.

Kahan will present an abstract of the study, available below, between 4:20 and 4:35 p.m. on Monday, Nov. 5, in the Plaza International Ballroom.

In addition, Dr. Milanaik will be among highlighted abstract authors available to the media after a brief presentation in the Press Office (room W208AB) at 12:40 p.m. EST on Saturday, Nov. 2. 

During the meeting, you may reach AAP media relations staff in the National Conference Press Room at 407-685-5404.

 

Please note: only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal. 

 

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org. Reporters can access the meeting program and other relevant meeting information through the AAP meeting website at http://www.aapexperience.org/

 

Abstract Title: Diversion of Prescription Antibiotics: Should You Take from Peter to Treat Paul

Tamara Kahan
Lake Success, NY

Purpose: Prescription medication borrowing and sharing, a practice known as diversion, is widespread for many medications including stimulants and analgesics, despite possible consequences such as adverse medical effects. A preliminary review of online blogs indicated that a substantial number of people engage in antibiotic diversion, despite warnings regarding the emergence of antibiotic resistant bacteria. However, to date, no studies have investigated the extent to which parents divert antibiotics prescribed for their children. The purpose of this study was to determine the prevalence of antibiotic diversion among parents, to whom the antibiotics are given, and how parents estimate the dosage of antibiotics to administer.

Methods: An anonymous online questionnaire was distributed to parents via Amazon Mechanical Turk. After indicating that they have reused antibiotics prescribed for their children, parents specified the formulation of antibiotics that were reused (liquid, drops, cream, tablet), the people to whom they have given their children's antibiotics, and how they determined the dosage of antibiotic to administer. Finally, parents stated whether they have given medications prescribed for adults to their child.

Results: A total of 496 parents (n=550; avg age=34.2; 39% Male; 15% Hispanic/Latino; 69% White, 17% Asian, 8% Black, 6% Other) met inclusion criteria. Of 454 parents who had leftover antibiotics (of any formulation), 219 (48.2%) reported saving them instead of disposing of them. Of those, 159 (72.6%) stated that they subsequently diverted those antibiotics. Antibiotic diversion predominated for liquids (80.4% of parents whose children used this formulation) and drops (73.8%) compared to creams (69.7%) and tablets (55.6%). Antibiotics were most often diverted from the child to whom the antibiotic was prescribed to the child's siblings and parents (Table 1). The dosage of antibiotic that was administered was typically the prescribed dosage, though the recipient of the antibiotic had changed, or was estimated based on the age of the child (Table 2). Overall, 16% of participants stated that they had given their child adult medications.

Conclusion: An alarming percentage of parents reported diversion of antibiotics both within and outside the family. This practice is dangerous not only for the new recipients of the antibiotics but for the population that will likely endure the consequences of drug resistant bacteria. It is imperative that clinicians emphasize the risks of antibiotic diversion and encourage proper disposal of antibiotics.


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