Big Brother’s Role in the Antibiotic Landscape

In the United States, everyone knows that antibiotics are like gold. For whatever reason, they are extremely hard to come by. Our government does not believe in or approve over-the-counter antibiotics. Other countries might find this surprising because most antibiotics in many countries around the world actually are sold over-the-counter. It’s interesting to compare the selling and distributions of the drugs in different countries, especially considering the fact that antibiotic resistance is a global problem.

Even for people that are aware of this over-the-counter phenomenon, the question of whether it’s good or bad still poses some puzzling questions. Why specifically do some countries sell over-the-counter, and why do others not? Additionally, which regulation method is better and why? Researchers have made strong points on both sides of this argument. Cons of over-the-counter antibiotic availability include overconsumption, avoiding necessary yearly doctor appointments, exposure to leftover antimicrobials, improper use, and the possibility of adverse drug reactions. Positive effects include convenience, affordability, and personal discretion. The person selling you the drugs doesn’t know precisely why you need them.

Although it seems like there are far more and far worse negative effects of over-the-counter antibiotics, that is not necessarily the case. Here is where the plot twist comes in. Countries with over-the-counter policies actually have far lower levels of abuse, improper misuse, and overconsumption. This revelation would lead us to believe that the policies themselves are not a problem, but rather the people abiding (or not abiding) by them. You would think that the countries where you can freely obtain antibiotics without government regulation or interference would be the countries with the highest abuse rates. However, countries such as Brazil, the Dominican Republic, and Honduras all have fewer reported cases of adverse drug affected patients and lower antibiotic usage rates in hospitals as compared to the United States year-over-year.

This brings into question the overall idea of government control and regulation as whole. If the government makes it so that U.S. citizens need a prescription, then why are we still overusing the drugs more than other countries? Not only that, but the government and medical professionals have come up with rules taking antibiotics. More specifically, antibiotics are “supposed” to be taken for 7–14 days, and they are strictly not for viral infections. Well why do they have to be taken for 7–14 days if you’re cure after 3? Wouldn’t taking an additional, and unnecessary, 4 days worth of medicine be exactly what we are trying to prevent? Maybe policies like that are contributing to overuse and antibiotic resistance. And to top it all off, I know for a fact that there have been several cases when antibiotics did work to cure a viral infection. I guess the main question is: is all of this oversight even necessary? You have countries with no oversight doing just fine, and here we are with all this chaos in the U.S.

To end my blog post, I’d like to leave you with an interesting story. Given everything I’ve said so far, do you believe that there could be a black market for over-the-counter antibiotics in the U.S.? The answer is yes. Fourteen years ago, an article was published in the New York Times about how bodega owners were selling antibiotics under-the-table in their corner stores all throughout Manhattan. That cycle has continued throughout all of these years. Many of the bodega owners are Dominican, and they’ve been smuggling in the pills from their home country to be sold on the streets if of New York. Patients interviewed in the article mentioned how they would go to certain, known bodegas to get antibiotics for a cough, cold, or fever. The bodega owners understand the affordability and convenience factors for the average New York citizens. If you don’t think the over-the-counter factor is a serious factor, just think about the inability of the New York Police Department to close down such illegal operations even after 14 years.