Antibiotics Without A Prescription: The Risks of Self-Medication

Antibiotics, sometimes known as antimicrobials, are a type of medication that is used to treat bacterial infections. They work by killing the bacteria or preventing them from growing. They are only available on prescription, and can rarely be accessed over the counter.

There are many different types of antibiotics, and each one is specific to certain types of infections. That's why it's so important to get a diagnosis before taking antibiotics, because it allows a doctor to be able to prescribe the right type of antibiotic for your infection.

There are hundreds of different types of antibiotics, but the main groups you will come across include:

• penicillins (e.g amoxicillin, co-amoxiclav and flucloxacillin) - chest, ear and dental infections.
• tetracyclines (e.g doxycycline, lymecycline and oxytetracycline) - used for sexually transmitted infections (STIs), dental absecesses, rosacea, acne and as an antimalarial.
• macrolides (e.g azithromycin, erythromycin and clarithromycin) - sinus infections, STIs, chest infections and lyme disease.
• fluoroquinolones (e.g ciprofloxacin) - conjunctivitis, skin, bone, ear and respiratory tract infections.
• cephalosporins (e.g cefalexin) - chest, skin and urinary tract infections.
• aminoglycosides (e.g gentamicin and tobramycin) - septicaemia, ear and eye infections.

These are the main antibiotic categories, but there are other common treatments that don’t fit neatly into these classes, including antibiotics for urinary tract infections (UTIs) such as trimethoprim and nitrofurantoin; antibiotics for bacterial vaginosis such as metronidazole; and chloramphenicol for eye infections.

It’s also important to note that antibiotics within the same category will treat different infections. Some antibiotics will be ‘broad spectrum’, meaning they can treat many kinds of infections, whereas ‘narrow spectrum’ antibiotics will only target specific bacteria. Thus, you should never assume what an antibiotic may or may not treat.

What can’t you treat with antibiotics?

The irrational use of antibiotics when you don’t need them can have the opposite adverse effect.

You should not use antibiotics to treat other microbial conditions such as:

• common cold, flu, coughs and sore throats
• genital herpes and genital warts
• other herpes infections (shingles, chicken pox or cold sores)
• HIV or AIDs
• genital or oral thrush
• fungal infections
• stomach flu (viral gastroenteritis)

Viral infections are one of the most prevalent cases of inappropriate use of antibiotics. For instance, one cross-sectional study conducted in India found that out of the respondents who had taken antibiotics, 25% self medicated for a sore throat, 22% for a fever and 14% for a cough.

Using antibiotics to treat these conditions will not treat them successfully and will also put you at a higher risk of experiencing unnecessary adverse drug reactions.

Yes and there are several reasons why.

First of all, antibiotics are powerful medications that can have serious side effects. They can also cause drug interactions and alter the efficacy of the medicines you already take. If they're not used properly, they can actually do more harm than good. That's why it's important to make sure that you're taking the right antibiotic for your infection.

Another danger of taking antibiotics when not needed is antibiotic resistance. This happens when bacteria become resistant to the antibiotics that are meant to kill them. When this happens, those antibiotics are no longer effective against that type of bacteria. These types of bacteria are known as ‘superbugs’ and can be fatal if not treated. Notable examples include MRSA (methicillin-resistant Staphylococcus aureus), clostridium difficile (C. diff) and some strains of tuberculosis.

The dangers of antibiotic resistance

Antibiotic resistance is a huge burden on public health for several reasons.

It means typical first-line antibiotic treatments for many infections become ineffective, meaning more expensive and risky interventions must be used. For instance, gonorrhoea (Neisseria gonorrhoeae) treatment used to involve a simple course of oral antibiotics. Now, it is much trickier to treat the high rates of gonorrhoea in the general population.

Drug resistance is also a significant risk factor for complications in those undergoing organ transplants, chemotherapy and other procedures. This is because these patients are more at risk of getting these infectious diseases, as their immune systems are compromised, and therefore more at risk of becoming quite ill if the antibiotic treatment they need is not effective.

It is also a leading cause of death worldwide, especially in hospitals and in those most vulnerable. One 2019 study published in the Lancet found that global morbidity rates for antimicrobial resistance were exceptionally high, with 4.95 millions deaths worldwide linked to antimicrobial resistance.

How do you prevent antibiotic resistance?

Rational use of antibiotics and taking them exactly as your primary care provider has instructed is the best way to alleviate antimicrobial resistance.

Guidelines for individuals from the World Health Organization (WHO) include:

• finish the full course of antibiotics, even if you start to feel better
• don’t exceed the dose you have been given
• never use or share leftover antibiotics from a previous infection
• don’t accept antibiotics from a family member
• don’t take antibiotics without being prescribed them by a healthcare professional
• don’t demand antibiotics if your healthcare provider thinks you don’t need them
• protect yourself from getting or spreading infections where possible (e.g cleaning your hands, practising safe sex, keeping up to date with your vaccinations and preparing food hygienically)
• take appropriate non-prescription medicines for cold and flu

The prevalence of self-medication is on the rise, as people are embarrassed to go to the doctor or just don’t want the hassle. In fact, data collection from one cross-sectional survey found that across several countries in Europe 485 respondents had used antibiotics to self-medicate out of the 4,138 who had ever taken antibiotics.

Efforts of public healthcare systems and local authorities have managed to reduce this number significantly, but multiple systematic reviews show there is still a high prevalence in developing countries like Ethiopia (47%), Pakistan (45%), Nigeria (41%) and Ghana (40%).

However, the practice of self-medication has by no means disappeared in more developed countries and according to the Centers for Disease Control and Prevention (CDC), up to 50% of antibiotic prescriptions issued by acute-care providers in the USA are inappropriate. This issue is especially exacerbated as many health services who offer antibiotic prescribing have moved online.

If you’re worried you have an infection, you should speak to your doctor before trying any treatment. You could also head to a community pharmacy where a pharmacist can see whether your symptoms require antibiotics, or whether there is a medicine available over the counter that can help you.

If you think you may have an STI, then you should head to a sexual health or GUM (genitourinary medicine) clinic and get tested. Most clinics will not require an appointment, and you can get checked out the same day. If you’re nervous or embarrassed about your symptoms, there are plenty of remote STI testing options available for free or through private healthcare providers.

Signs of an infection

Some general warning signs of some common infections include:

• fever
• feeling and/or being sick
• chills and sweats
• a new cough or change in your cough
• shortness of breath
• sudden pain or ache
• redness, soreness, warmth or swelling in any area
• increased urination
• unusual genital discharge or irritation
• swollen lymph nodes
• pus from a recent wound or incision
• stiff neck
• confusion
• sensitivity to bright light

Having one of these symptoms won’t always signal an infection, but these are some general indicators that you may need antibiotics if you’re ever not sure.

Yes, you can get prescription antibiotic treatment online. However, you must ensure that the online source of antibiotics is credible. Check that the antibiotics are being prescribed by registered doctors and dispensed by a registered pharmacy.

At euroClinix, you can get antibiotics online to treat several conditions such as acne, UTIs, and STIs including chlamydia (provided you have had a positive result from an STI test). The antibiotic doxycycline is also used to prevent and treat malaria if you’re travelling to a high-risk area.

All you have to do is fill out a medical questionnaire that confirms your medical history and a diagnosis if applicable.Then based on that information, our UK registered doctors can prescribe a suitable antibiotic for you. Our pharmacy then dispenses the prescription and sends the medication discreetly to you the next day.

Our service removes all the hassle of wait times and in-person appointments but still maintains the same quality of care and safety of our patients.

Can you buy antibiotics over-the-counter?

No, you will always require a prescription from your doctor or healthcare professional to buy antibiotics.