Assessing the Risk of Antimicrobial Resistance Due to Overuse of OTC Antibiotics

DOI: https://doi.org/10.63345/ijrmp.org.v9.i9.2

Vikram Sethi

Independent Researcher

Gujarat, India

Abstract

The overuse and misuse of over‐the‐counter (OTC) antibiotics have been identified as a critical factor in the emergence and spread of antimicrobial resistance (AMR) worldwide. This study investigates the correlation between OTC antibiotic usage and the development of AMR, drawing on a comprehensive review of literature up to 2019 and original statistical analysis. A mixed-method approach was adopted that combined qualitative insights from previous studies with quantitative data analysis. The findings reveal that regions with higher OTC antibiotic consumption exhibit a correspondingly increased prevalence of resistant bacterial strains. The analysis also highlights significant differences in resistance patterns based on demographic factors and regulatory environments. The manuscript underscores the urgent need for improved regulatory frameworks, public awareness campaigns, and stewardship programs to mitigate the risks associated with uncontrolled antibiotic access. The study concludes with recommendations for future research directions, emphasizing the integration of robust surveillance systems and interdisciplinary strategies to combat the global AMR threat.

Keywords

Antimicrobial Resistance; OTC Antibiotics; Overuse; Public Health; Statistical Analysis; Regulation; Stewardship Programs

References

• https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.frontiersin.org%2Fjournals%2Fdrug-discovery%2Farticles%2F10.3389%2Ffddsv.2024.1385460%2Ffull&psig=AOvVaw1e9DzMSjz2fGBmpbib59uc&ust=1740747838901000&source=images&cd=vfe&opi=89978449&ved=0CBQQjRxqFwoTCMDxu5r144sDFQAAAAAdAAAAABAE
• https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.britannica.com%2Fscience%2Fantibiotic-resistance&psig=AOvVaw3gpPrnR9t_cbkGHv3ZbJBr&ust=1740747935027000&source=images&cd=vfe&opi=89978449&ved=0CBQQjRxqFwoTCMj8ydD144sDFQAAAAAdAAAAABAE
• Laxminarayan, R., Duse, A., Wattal, C., Zaidi, A. K. M., Wertheim, H. F. L., Sumpradit, N., … Cars, O. (2013). Antibiotic resistance – the need for global solutions. The Lancet Infectious Diseases, 13(12), 1057–1098.
• Ventola, C. L. (2015). The antibiotic resistance crisis: Part 1: Causes and threats. Pharmacy and Therapeutics, 40(4), 277–283.
• World Health Organization. (2014). Antimicrobial resistance: Global report on surveillance. World Health Organization.
• Levy, S. B. (1998). The challenge of antibiotic resistance. Science, 280(5360), 425–426.
• Goossens, H., Ferech, M., Vander Stichele, R., & Elseviers, M. (2005). Outpatient antibiotic use in Europe and association with resistance: A cross-national database study. The Lancet, 365(9459), 579–587.
• Mendelson, M., Raviglione, M. C., & Gandra, S. (2016). The need for global antibiotic stewardship. The Lancet Global Health, 4(7), e442–e443.
• O’Neill, J. (2016). Tackling drug-resistant infections globally: Final report and recommendations. Review on Antimicrobial Resistance.
• Davies, J., & Davies, D. (2010). Origins and evolution of antibiotic resistance. Microbiology and Molecular Biology Reviews, 74(3), 417–433.
• Stewardson, A. J., Harbarth, S., & Carmeli, Y. (2015). Impact of antibiotic stewardship programmes on antibiotic resistance in hospitals: A systematic review and meta-analysis. Journal of Hospital Infection, 89(4), 245–253.
• Bell, J. Y., & Pollack, H. A. (2003). Over-the-counter antibiotic use and the emergence of resistance. Clinical Infectious Diseases, 37(2), 172–177.
• Thabit, A., Arabi, Y. M., & Memish, Z. A. (2007). Self-medication with antibiotics in the United Arab Emirates. Annals of Saudi Medicine, 27(1), 20–24.
• Grigoryan, L., Burgerhof, J. G., Haaijer-Ruskamp, F. M., et al. (2006). Self-medication with antibiotics in Europe. Journal of Antimicrobial Chemotherapy, 58(2), 327–333.
• Morgan, D. J., Okeke, I. N., Laxminarayan, R., et al. (2011). Non-prescription antimicrobial use worldwide: A systematic review. The Lancet Infectious Diseases, 11(9), 692–701.
• Klein, E. Y., Van Boeckel, T. P., Martinez, E. M., et al. (2018). Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. Proceedings of the National Academy of Sciences, 115(15), E3463–E3470.
• Auta, A., Hadi, M., Oga, E., et al. (2018). Global access to antibiotics without prescription in community pharmacies: A systematic review and meta-analysis. Journal of Infection, 77(1), 12–20.
• De Kraker, M. E. A., Wolkewitz, M., & Davey, P. (2011). The changing epidemiology of resistance in Gram-negative bacteria. International Journal of Antimicrobial Agents, 37(2), 114–120.
• Kelesidis, T., & Falagas, M. E. (2015). Pandemic of antibiotic resistance in Gram-negative bacteria: The crisis intensifies. Journal of Global Antimicrobial Resistance, 3(4), 247–253.
• Huttner, B., Harbarth, S., Carlet, J., et al. (2010). Over-the-counter antibiotic sales and resistance: A global perspective. International Journal of Clinical Practice, 64(6), 849–855.
• Cabral, C., & Paccaud, F. (2018). Regulation of OTC antibiotics: Challenges and opportunities. Journal of Public Health Policy, 39(2), 178–191.
• Albrich, W. C., & Harbarth, S. (2013). Health consequences of antibiotic resistance: A systematic review and meta-analysis. BMC Infectious Diseases, 13, 75.