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When Americans need antibiotics, some are ordering them online—supposedly for their pet fish. Although marketed for guppies and goldfish, such antibiotics are being used for self-medicating, according to a recent study.
Brandon Bookstaver, PharmD, presented these findings Wednesday at a meeting of the American Society of Health-System Pharmacists (ASHSP) in Las Vegas.
"While human consumption of fish antibiotics is likely low, any consumption by humans of antibiotics intended for animals is alarming," Bookstaver said in a press release. "Self-medication and the availability of antibiotics without healthcare oversight might contribute to increasing antimicrobial resistance and delayed appropriate treatment. We were particularly concerned that the high volume of positive feedback on the comments about human use might encourage others to attempt to use these drugs."
Unlike antibiotics for cats, dogs, or human beings, anyone with a credit card can order fish antibiotics online without a prescription. Study authors obtained five samples of these drugs, and found that they have the same markings, colors and shapes of the same drugs used for humans. Further study is intended to discover how similar these drugs are to human antibiotics.
A 2017 study found that Americans use such drugs to make up for insurance gaps or to avoid a day of missed work in lieu of a visit to the doctor.
"Unlike antibiotics for humans or other animals, these medications are completely unregulated by the Food and Drug Administration," Ganio said. "Even if the pills look the same, it's impossible to know that medications purchased in this manner contain what the label says and are safe for humans."
How Do Antibiotics Work?
Antibiotics are used to treat bacterial infections, according to Melissa Conrad Stöppler, MD, a medical author at MedicineNet. They do this by either stopping bacterial growth or killing bacteria directly.
While they are helpful against many bacteria, these drugs are useless in the face of a viral infection, Dr. Stöppler said. She adds that most colds and sore throats are caused by viruses.
"In fact, taking antibiotics when they are not really necessary will not speed your recovery and can even contribute to a problem known as antibiotic resistance," she said.
What Is Antibiotic Resistance?
Many bacteria can become resistant to a particular antibiotic through mutation, according to MedicineNet author John P. Cunha, DO, FACOEP.
"That allows them to grow in the presence of a drug (an antibiotic) that would normally slow their growth or kill them," Dr. Cunha said. And that leads to more infections. About 2 million Americans are infected with antibiotic-resistant microbes every year, according to CDC statistics.
Dr. Cunha offers several causes of antibiotic resistance:
- Inappropriate Use: Inappropriate use of antibiotics can occur, such as when a healthcare provider will prescribe an antibiotic because an insistent patient has demanded it, even without a diagnosis.
- Inadequate Diagnostics: Sometimes broad-spectrum antibiotics are used even when a specific antibiotic might be better because there is incomplete or imperfect information to diagnose an infection. This contributes to selective pressure.
- Hospital Use: Critically ill patients are more susceptible to infections and they frequently need antibiotics, but this increased use along with close contact among sick patients creates an environment where antimicrobial-resistant germs can spread easily.
- Agricultural Use: Adding antibiotics to agricultural feed can promote drug resistance.