State Of American Healthcare-Humans Resorting To Consuming Antibiotics Meant For Fishes and Aquaculture
American consumers seeking cheaper, faster access to antibiotics are apparently consuming antibiotics intended for treating fish and aquaculture rather than humans, according to research presented at the ASHP (American Society of Health-System Pharmacists) 54th Midyear Clinical Meeting and Exhibition. Currently, there are shortages of various antibiotics in the US and prices of antibiotics are extremely high compared to other places in the world. Prices of a pack of ten 500 mg tablets of Augmentin costs almost 16 times more than that in Thailand!
The shortages and high prices have lead to the consumption of antibiotics
meant for aqualculture
that may lead to dangerous unintended consequences such as adverse side-effects, treatment failures, and antibiotic
drug resistance, said co-author Brandon Bookstaver, Pharm.D., director of residency and fellowship training at the University of South Carolina College of Pharmacy.
Researchers investigated the broad range of this potential misuse by conducting a comprehensive review of the online fish antibiotic
market, along with all customer reviews and comments available on websites that sell fish antibiotics
in the United States.
Bookstaver said, "While human consumption of fish antibiotics
is moderate, any consumption by humans
intended for animals is alarming. 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."
Whereas there are stringent policies in place for antibiotics
prescribed for dogs and cats, fish antibiotics
are currently available over the counter and do not require a prescription. Researchers identified nine different antibiotics
for sale online at 24 different websites, ranging in prices from $8.99 for a bottle of 30 capsules of amoxicillin (250mg per capsule) to $119.99 for a bottle of 100 ciprofloxacin tablets (500mg per tablet).
Although the number of online product reviews associated with human consumption
was low (2.4 percent or only 55 comments out of the 2,288 reviewed), the attention generated by those reviews, in terms of "likes" and "dislikes," exceeded other reviews by a ratio of 9-to-1. On average, reviews discussing human consumption of fish antibiotics received 9.2 likes compared to just 1.3 likes for those not mentioning human consumption
. In addition, one vendor responded to a question online and asserted that the fish pills were suitable for human use.
Researchers of the study also obtained and examined five antibiotics
that were being marketed online for fish: amoxicillin, penicillin, cephalexin, metronidazole, and sulfamethoxazole-trimethoprim and discovered that they carry the exact imprints, color, and shape of available products meant for human consumption
. Study authors plan to verify the contents of the antibiotics as a next step in their research.
Most of the products were made in China, Mexico and Brazil while some even had US trademarks.
ASHP Director of Pharmacy Practice and Quality Michael Ganio, Pharm.D., M.S., BCPS, CPHIMS, FASHP, said pharmacists can play a critical role in helping patients access safe and appropriate medications and in educating people about the dangers of taking antibiotic
s not prescribed to them.
Ganio told Thailand Medical
News, "What might seem like a less expensive, easier way to treat an assumed infection can ultimately have very serious negative consequences. Unlike antibiotics
for humans or other animals, these medications are completely unregulated by the US Food and Drug Administration. 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. Antibiotics
, like all medications, should be dispensed from a licensed pharmacy after a diagnosis and prescription from a medical professional."
The fact that humans are having to resort to buy antibiotics
meant for fishes is a reflection of the state of healthcare
Reference: The research entitled Fishy Business: Online availability of fish antibiotics and documented intent for self-medication was presented at the ASHP 54th Midyear Clinical Meeting and Exhibition on Wednesday, Dec. 11, 2019.