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The following is a summary of “A screening question to assess risk of using antibiotics without a prescription: a diagnostic study,” published in the April 2025 issue of BMC Primary Care by Collazo et al. 

Non-prescription antibiotic use is unsafe and drives antimicrobial resistance. Identifying users can support targeted stewardship efforts. 

Researchers conducted a prospective study to identify predictors of prior non-prescription antibiotic use. They also assessed if a screening question could predict future intention of such use. 

They conducted a survey from January 2020 to June 2021 in six public primary care clinics and 2 private emergency departments. Prior non-prescription users were those reporting oral antibiotic use without clinician contact; intended use was defined by a yes to future use without contacting a provider. Predictors of prior use and sensitivity, specificity, PPV, and NPV were calculated for any prior use and use in the past 12 months. 

The results showed 246 of 564 respondents (43.6%) reported non-prescription use; 91 (37.0%), or 16.1% overall, did so in the past 12 months. About 63% had previously been prescribed the same antibiotic. Sensitivity was 75.9% (95% CI: 65.3–84.6), specificity 91.4% (95% CI: 87.8–94.2), PPV 74.5% (95% CI: 66.7–80.9), and NPV 93.7% (95% CI: 90.5–96.1). 

Investigators proposed a method to screen for future non-prescription antibiotic use. They suggested it may support antimicrobial stewardship in primary care settings. 

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-025-02811-3