[Spivak]

I go further and say that you should be able to buy any drug from the pharmacy without a prescription*. As well as testing kits. Having to have an ongoing relationship with a doctor just to refill your medication or get antibiotics when you get strep is a huge waste of everyone's time and money. And there are countries where you can already do this and they haven't collapsed. It makes the job of pharmacist actually matter as someone other than a pill counter.

It ends so many stupid discussions we have in the US. Can this medication be prescribed for an off-label use? Who cares because you can just buy it. Do you meet some arbitrary federal weight guideline for Ozempic? Who cares you can just buy it.

* every rule has exceptions, don't get bogged down with them.

[MandieD]

Two words that explain why it hurts everyone else when you can go buy antibiotics whenever you want (you think you have strep):

Antibiotic Resistance.

Longer explanation: how do you know exactly which bacteria you’re infected with, and which antibiotics will work well against them, and which ones they’ll throw a middle finger at? Even if you have the exact same symptoms as the last time, how do you know that taking the same antibiotic will work just as well, and won’t just further select for bacteria it has no effect on?

[Spivak]

My apologies, I'm using strep in the layman's terms meaning any bacterial sinusitis.

This is great and all but it ignores that getting an antibiotic prescription is not difficult at all. I literally just get in a video call, describe the symptoms of strep, and they write me a prescription. It's less expensive to treat than to test. In 15 years I've never had a doctor actually test me for what bacteria I actually have. They sometimes do the bare minimum of looking at it to be pretty confident it's bacterial but that's about it.

However stupid you think the general populace is, doctors count themselves among their numbers. Your average urgent care or primary care doc is just going to give the same broad spectrum antibiotics without any real thought. Except for the one bona-fide MD who looked at my very obvious case of strep, knowing from my chart that I have chronic bacterial sinusitis, and me telling them as much, looking at my puss filled tonsils and concluding that it's allergies and that I should take Claritin. Never go to urgent care man.

[LorenPechtel]

This.

I believe all recreational drugs should either be legal or else available by prescription with the explicit statement in the law that addiction management is a valid reason for a prescription. None of the controlled substances hoops. And I think *renewing* maintenance meds should be within the realm of the pharmacist.

But I think all agents for which resistance is a factor should be doctor only.

[bediger4000]

If use of a drug had no, or very little externalities, id agree. Overuse of antibiotics creates resistant bacteria, endangering everyone. I am forced to disagree civilly, sir.

[mystraline]

A large portion of antibiotic resistance comes from patients taking a partial prescription, feeling better, and discontinuing the rest of the pills.

In that situation (the only one at this time), is the majority of resistances are made.

Controlling the supply, especially if you know you have a bacterial disease, can be solved readily.

In fact, on a camping trip, I was bit by 15 ticks. Was bad. When I got back to civilization, I started getting spots all over my body. Surprise, it was rocky mountain spotted fever. But if I could determine the 2 drugs for curing spotted fever and Lyme, I absolutely would have did both. But the shitty gatekeeper (doctor) wouldn't do Lyme course. Again, logically made a lot of sense, especially that Lyme tests are 60% accurate. And, 15 ticks.

[bediger4000]

You're not really saying that the populous would finish more courses of over-the-counter antibiotics, are you? Prescriptionless antibiotics would almost axiomatically make that worse.

[Spivak]

I actually kind of disagree, when you can get more at any time there's no reason to want to save any of them.

[bediger4000]

Most people quit taking the antibiotics when they feel better, not to save some for a rainy day.

[Spivak]

So then what's the fear? If they take antibiotics for a bacterial infection and don't finish it's same as the current state of the world. If they take antibiotics for a viral infection and don't finish them then no harm no foul if you believe the theory that this is how resistance occurs.

Hard to create a strain of antibiotic resistant bacteria when you didn't have any in your system to begin with. Turns out you can't #gatekeep #girlboss your way out of this and have to educate your way out regardless if antibiotics are behind-the-counter non-prescription or not.