Where and the way did you get this antibiotic?

At the community clinic where I volunteer, we serve uninsured and underinsured individuals, a lot of whom are migrant farmworkers. They often don’t speak English, and there are numerous cultural differences. I learned lots caring for these patients. Coming from a background in critical care, I used to be not used to patients who could walk and talk, let alone seek look after work-related wounds and injuries along with basic care needs.

One patient got here in with several sores on his feet. His every day work required him to face for long hours within the fields. He wore heavy boots that weren’t waterproof, and judging by his socks, it was difficult for him to maintain his feet clean and dry. The sores were inflamed, with yellow discharge, hot, and painful. With the assistance of an interpreter, we asked the standard questions—When did you first notice these sores? Do you’ve gotten them elsewhere? Have you ever had them before? Have you tried any treatment?

During our conversation, we learned that he had been taking penicillin. Great, we thought, he had already been to the doctor and the injuries had already been taken. Wrong. He explained that a shopkeeper in his neighborhood had given him some pills. He showed us the package and, sure enough, it was a type of penicillin. He had bought it at an area market.

I used to be shocked. For me, antibiotic stewardship meant withholding antibiotics for my children with earaches, waiting for a respiratory virus to declare itself viral or bacterial, or waiting for culture results. I used to be naïve in my lack of information that antibiotics were available—in grocery stores, in medicine cabinets (“saving a few for next time”), and within the pockets or purses of neighbors and friends. Wow!

AND last review published in found that the prevalence of over-the-counter antibiotic use ranged from 1% to 66%, depending on population characteristics. Factors that contributed to over-the-counter antibiotic use included easy accessibility in markets or stores that provide prescription antibiotics worldwide, difficulties in accessing the healthcare system, costs of doctor visits, long waiting times in clinics, and transportation problems (Grigoryan et al., 2019).

This is an urgent public health issue, and my latest experiences locally have really opened my eyes to the issue. We can do higher—but how? In 2017, the American Nurses Association and the Centers for Disease Control and Prevention published Redefining the Antibiotic Stewardship Team: Recommendations from an American Nurses Association/Centers for Disease Control and Prevention Task Force on the Role of Registered Nurses in Hospital Antibiotic Stewardship Practices. The working group addresses 4 key questions:

1. What role can and may nurses on duty play in efforts to enhance antibiotic use?
2. What educational and training resources are needed to assist nurses fulfill these roles?
3. How can we higher engage nurses and encourage them to take part in antibiotic stewardship programmes?
4. What can we do to interact nursing leaders in care activities?

I encourage you to download it white paper (It’s free.) Review the suggestions for every of those questions and find out how you possibly can make a difference.

Grigoryan, L., Germanos, G., Zoorob, R., Juneja, S., Raphael, J., Paasche-Orlow, M., and Trautner, B. (2019). Over-the-counter antibiotic use within the US population: a scoping review. doi: 10.7326/M19-0505

American Nurses Association/Centers for Disease Control and Prevention Workgroup. (2017). The Role of Nurses in Hospital Antibiotic Stewardship Practices. Retrieved from https://www.cdc.gov/antibiotic-use/healthcare/pdfs/ANA-CDC-whitepaper.pdf