In today’s “the U.S. healthcare system is utterly broken” news, a study has found evidence that some people are buying fish antibiotics online to use on themselves—presumably because they’re cheaper than visiting the doctor to get a proper prescription.
Researchers from the University of South Carolina examined online reviews from 24 websites selling nine kinds of fish antibiotics. Out of the nearly 2,300 reviews they looked at, 55 reviews (2.4 percent) seemed to indicate that the customers were buying the product for human use. While these reviews were few and far between, they received more attention and positive likes from other users than typical reviews did. The team also found at least one retailer who assured customers that the antibiotics were fine to use in people, in response to a question.
The preliminary, not yet peer-reviewed research was presented Wednesday at the midyear clinical meeting of the American Society of Health-System Pharmacists (ASHP).
“While human consumption of fish antibiotics is likely low, any consumption by humans of antibiotics intended for animals is alarming,” said study author Brandon Bookstaver, an assistant professor in the University of South Carolina’s College of Pharmacy, in a statement provided by the ASHP.
Although it’s unclear why exactly these people turned to fish drugs, Bookstaver and his team noted that these antibiotics are much less regulated than those sold for people, livestock, and pets like cats and dogs.
Cost-wise, they’re likely cheaper than what you’d pay for the human version out-of-pocket without insurance. In the study, for instance, they found a bottle of 30 capsules of 500 milligram amoxicillin sold for $8.99, while the same quantity might run as high as $32 at Rite Aid at retail price, according to a search on GoodRX. That comparison also doesn’t take into account the added expenses and time spent on a doctor’s visit, while the fish antibiotics are bought over the counter.
These drugs—at least according to their labels—may not be functionally different in ingredients than the version you’d get from a doctor, but because they’re unregulated, there’s no telling whether people are actually getting what the labels promise. And even if they’re the real deal, people could still be opening themselves and others up to a bevy of added risks. Doctors already tend to overprescribe antibiotics when they aren’t needed (like for the common cold), which drives up the risk of bacteria becoming resistant. And antibiotics aren’t side-effect free, especially if you have no idea what dosage to take and for how long.
Anecdotally, at least some doctors have apparently encountered patients who used fish antibiotics with dire consequences.
“One of my patients took fish antibiotics because she didn’t have health insurance,” Farzon Nahvi, a New York-based emergency department physician, told the Guardian. “She overdosed, ended up in the intensive care unit, and ended up far more ill and—having no insurance —with an even bigger bill. Plus, she missed a job interview, which could have been her ticket to health insurance, because of her hospital stay.”
While it’s all well and good to tell people not to use fish antibiotics, the underlying reasons—rising health care costs, stagnant wages—aren’t such an easy fix.
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