There is growing concern over increasing rates of microbial resistance to antibiotics and a growing body of evidence linking that resistance to the excessive use of antibiotics. Knowing that there are numerous reasons for inappropriate use, nurse researcher Elaine Larson and colleagues studied the antibiotic use in one Hispanic community in New York City to determine the prevalences of infection and antibiotic use, as well as the sources of the antibiotics.

The researchers conducted interviews in more than 600 Spanish-speaking households, asking whether family members had been ill during the previous month and, if so, how many had used antibiotics to treat the illness.

In approximately a third of the households there had been at least one ill family member; the presence of illness was determined on the basis of symptoms described: respiratory symptoms, fever, vomiting, diarrhea, or skin infection. Almost half of those with symptoms sought medical treatment, and 39% received an antibiotic, even though most of the reported symptoms appeared to be viral in nature (for which antibiotics would be ineffective). The researchers also discovered that antibiotics were available over the counter in local bodegas (Hispanic grocery stores), and many respondents reported that medications were saved and shared among family and friends.

Coauthor of the study, Elaine Larson, says, "Many new immigrants come from countries in which antibiotics are available over the counter and are taken for even minor symptoms, and they bring this expectation with them to the United States." Efforts to teach the appropriate use of antibiotics have been focused primarily on those within the traditional health care system, such as the insured. "Large proportions of the population, such as recent immigrants, the uninsured, and those whose first language isn't English, aren't being given enough information on this topic."

Larson E, et al. Emerg Infect Dis 2003;9(9): 1096-102.