ArticleBMJ public health2025
'Antibiotics are like gold': a qualitative study of patient perspectives on the use of antibiotics without a prescription.
Article in BMJ public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- 'In Texas, everybody wants antibiotics': reducing inappropriate antibiotic expectations and use with a provider-patient communication tool in primary care.Family medicine and community health · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Using antibiotics without a prescription (non-prescription use) is common in the USA and contributes to antibiotic misuse, potentially harming individuals and threatening public health. At the individual level, safety issues related to non-prescription use include adverse drug reactions and disruption of healthy microbiomes. At the public health level, non-prescription use increases the risk of antimicrobial resistance. Objectives: This qualitative study explored the reasons and motivations underlying non-prescription use among adult outpatients with varying healthcare coverage and education. Methods: We used purposive sampling to recruit participants who endorsed using non-prescription antibiotics in a larger quantitative survey. Participants were patients recruited from six public and two private clinics in Houston and Katy, Texas. All interviews were semistructured and conducted remotely by trained research coordinators in the participant's preferred language (English or Spanish). Interviews captured elements from two domains of the Kilbourne Theoretical Framework for Advancing Health Disparities Research, including patients' attitudes and beliefs, resources and various healthcare-system factors that could impact non-prescription use. Thematic analysis revealed the factors and situations that contribute to non-prescription use. Results: Of 86 participants surveyed, 72% were female and 24% had Medicare or private insurance. Our thematic analyses on why participants use non-prescription antibiotics are organised into two domains: (1) patient beliefs and experiences and (2) healthcare system barriers. Patient beliefs and experiences revealed four themes: (1) belief that antibiotics relieve many symptoms/illnesses (eg, pain, sore throat, if symptoms/illnesses are persistent, lingering or severe), (2) belief that patients know their own bodies (eg, participants' perceived self-efficacy in knowing and using medications for their illnesses/symptoms), (3) belief that over-the-counter medicines do not work and (4) belief that antibiotics are like gold (eg, antibiotics are difficult to obtain, valuable and highly effective). Healthcare system barriers revealed two themes: (1) patients encounter obstacles to healthcare (eg, transportation, long wait times, high healthcare costs and lack of reliable telemedicine options) and (2) patients express convenience in using non-prescription antibiotics from multiple sources (eg, leftover prescriptions, social networks or purchased without a prescription). Conclusions: Barriers to care, the convenience of obtaining non-prescription antibiotics, and patients' beliefs regarding the powerful value of antibiotics and their agency to direct this aspect of care present challenges that need to be explored to design effective outpatient antibiotic stewardship programmes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.