In the United States, Hispanic patients are almost twice as likely as all patients to believe that taking antibiotics reduces cold symptoms, and nearly three times as likely to obtain antibiotics not prescribed by a clinician, according to a report published in the July 23 issue of the Morbidity and Mortality Weekly Report.

"Appropriate antibiotic use, in particular avoidance of antibiotics for upper respiratory infections likely to be caused by viruses, is a key component of efforts to slow the increase in antibiotic-resistant infections," write Louise K. Francois Watkins, MD, from the Epidemic Intelligence Service and Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, and colleagues. "Studies suggest that Hispanic consumers might differ from non-Hispanic consumers in their knowledge and attitudes regarding antibiotic use."

To evaluate this hypothesis further, the Centers for Disease Control and Prevention analyzed national Internet survey data from three groups of US residents during 2012 to 2013: adult consumers of all ethnicities, adult Hispanic consumers, and healthcare providers.

Nearly half (48%) of Hispanic consumers believed antibiotics would help them get better more quickly if they have a cold compared with one quarter (25%) of all consumers. Hispanic consumers were also less aware of potential dangers of antibiotic use, such as the development of antibiotic resistance, although awareness of adverse effects was similar between Hispanics and all consumers.

Hispanic consumers were also more likely than all consumers to obtain antibiotics not prescribed by a clinician, such as antibiotics left over from a previous illness (25% vs 9%), purchased at a neighborhood grocery store (23% vs 5%), or obtained from a friend or family member (17% vs 6%).

"To maximize knowledge about appropriate antibiotic use among outpatients in the United States, public health initiatives should target Hispanic as well as general audiences," the report authors write.

About one quarter (26%) of all consumers expected to receive antibiotic prescriptions when seen for a cough or cold, but more than half (54%) of providers believed their patients expected this. The report authors note that the US annual prevalence of infections that are resistant to antibiotics exceeds 2 million, and that antibiotics should be used only when prescribed by a health professional and only in the manner prescribed. The findings of this survey are therefore alarming, as unnecessary antibiotic use may increase the risk for antibiotic-resistant infections and preventable adverse events, including serious allergic reaction or Clostridium difficile diarrhea.

"Consumer education needs to emphasize both the limited circumstances in which respiratory infections require an antibiotic and the individual and population-level harms of inappropriate antibiotic use," the authors conclude. "Public health initiatives might target Hispanic as well as general audiences and consider cultural differences in health knowledge and attitudes, for example, through the use of culturally appropriate materials made available in both English and Spanish."

Limitations of this report include selection bias, inclusion of Hispanics in the sample of all consumers, and inability to determine differences between Hispanic subgroups based on acculturation status or ethnic origin.

The authors have disclosed no relevant financial relationships.

Morb Mortal Wkly Rep. 2015;64:767-770. Full text