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You Can’t Buy Antibiotics Over The Counter, Can You? (Yes, You Can.)

In yesterday’s post analyzing the Food and Drug Administration’s report on sales of antibiotics for use on farms in 2014, I noted that almost 99 percent of the antibiotics sold for agricultural use are sold over the counter, that is, without a prescription.

The FDA is attempting to change this, via an updated rule called the Veterinary Feed Directive; once that rule is finalized, livestock producers should only be able to obtain antibiotics once they have an “order” from a veterinarian. The goal here is to build more accountability into antibiotics purchase and use, because any misuse creates the possibility of resistance; and there is more use of antibiotics in agriculture, by sheer volume, than in human medicine.

As often happens when I talk about this, I ran into some disbelief: people protesting that, come on, surely you can’t just walk into a store and buy antibiotics, can you?

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Almost 99 percent (sum of the yellow boxes) of the antibiotics sold for use in food animals in the US are sold over the counter, that is, without a prescription.

In response, I posted a picture of two pounds of aureomycin (generic name, chlortetracycline) that I bought online without anyone asking me anything except my credit card number.

Simultaneously, Twitter follower Jonathan Sellman, MD, an infectious diseases specialist in the Twin Cities who heard me discuss this on MPR News with Kerri Miller, grew impatient with a caller who didn’t believe this happens, and decided to demonstrate that it does. He went down to a local farm-supply store, photographed several shelves full of antibiotics, and tweeted the images. He was soon backed up by Tim Johnson, PhD, a professor who researches antibiotic resistance, and by Peter Bornstein, MD, MBA, another infectious diseases physician; they both contributed images and links.

Up top, I’ve put together a quick slideshow. The answer to the question, Is it really as easy as it seems to buy antibiotics over the counter, and to use them without anyone looking over your shoulder to make sure you use them correctly?, is: Yes, actually, it is. Click through to see what we found.