Some New York City stores are selling antibiotics illegally over the counter

In many countries around the world antibiotics are sold without a prescription, a practice that is illegal in the United States. Yet some New York City stores that primarily serve the Hispanic community are selling these drugs over the counter, which adds to the growing problem of antibiotic resistance, according to a study being presented at the 42nd Annual Meeting of the Infectious Diseases Society of America (IDSA).

• Stores in Hispanic neighborhoods in New York City sold antibiotics without a prescription, while stores in other neighborhoods did not, according to a study.
• Antibiotics are available without a prescription in countries in Central and South America and in developing countries worldwide.
• Such misuse of antibiotics is adding to the alarming growing problem of bacteria becoming resistant to the drugs.

Researchers found that antibiotics were available without a prescription in stores in Hispanic neighborhoods, but not in stores located in other neighborhoods.

In the United States, as in Canada, most European countries, New Zealand and Australia, it is illegal to sell antibiotics without a prescription.

"In Central and South American countries and developing countries around the world, it's perfectly legal to buy antibiotics over the counter," said the study's principal investigator, Elaine Larson, PhD, RN, associate dean for research at the Columbia University School of Nursing, New York. "These store owners really believe they're doing their customers a service, although it's illegal in this country."

Antibiotic drugs have saved millions of lives, but they are not always effective. Over time, bacteria can develop resistance to existing drugs, making infections difficult if not impossible to treat. Drug-resistant infections can strike anyone, young or old, healthy or chronically ill, according to IDSA.

Inappropriate use of the drugs adds significantly to the resistance problem. Antibiotics work only for bacterial infections, but are not effective against viral infections. Further, specific antibiotics are only effective against specific bacteria: All antibiotics will not treat all bacterial infections. When available over the counter, antibiotics very often will be taken inappropriately, resulting in ineffective therapy and adding to the growing resistance problem.

"Much of the world is trying to get a handle on antibiotic use, and resistance is a huge problem right now," said Dr. Larson. "The problem is, when we do need the antibiotics, they may not work. In developing countries where antibiotics are sold over the counter, many of the antibiotics don't work anymore against illnesses that used to be easily treatable, such as pneumonia, cholera and gonorrhea."

While attending a medical meeting on antibiotic resistance, Dr. Larson was shocked to learn that antibiotics were available over the counter in her own New York City neighborhood.

So she decided to initiate the study, sending research assistants into 101 stores in three New York City neighborhoods: one primarily Hispanic, one primarily black and one primarily white. Antibiotics were available without a prescription in all 34 stores in the Hispanic neighborhoods, called bodegas, but in none of the other stores. Antibiotics were on the shelf in seven of the 34 Hispanic-neighborhood stores, and available by request in all of the others.

Study participants who didn't see antibiotics on the shelf in Hispanic stores were given such medications if they asked for something stronger than over-the-counter medicine for a sore throat. None ever asked directly for an antibiotic.

The Bodega Association of the United States represents 7,000 stores throughout the state of New York. "We are working with the association to determine the best way to educate bodega owners about the problem with selling antibiotics without a prescription," said Dr. Larson.

IDSA is an organization of physicians, scientists and other health care professionals dedicated to promoting human health through excellence in infectious diseases research, education, prevention and patient care. Major programs of IDSA include publication of two journals, The Journal of Infectious Diseases and Clinical Infectious Diseases, an Annual Meeting, awards and fellowships, public policy and advocacy, practice guidelines and other membership services. The Society, which has 7,500 members, was founded in 1963 and is headquartered in Alexandria, Va.

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