ANTIBIOTIC SAFETY

At Survival Scripts, we are acutely aware of the growing trend of antibiotic resistance. This phenomenon is due to a combination of personal misuse, inappropriate prescribing, and from use of antibiotics in large-scale factory farming practices. REMEMBER, the medications provided in our kits are meant to RESERVE for times when other care would not be accessible. We also strongly believe that if one follows the instruction guide, it will help them decide whether taking any medication in our kit is appropriate. The intention of prescribing the medications ranges from prophylactic use, empiric use (based most likely pathogens to be involved depending on the location, organ system, and well-known signs and symptoms of commonly encountered infections), PRN (as needed) use for symptom management, or for emergency use when no other resources or information are available. In emergency use cases, where there may be more of a guessing dynamic on if one should take one of the medications, we suggest that you promptly seek in-person evaluation to confirm whether the medication is appropriate to take for your situation. 

To maintain the standards and integrity of prescribing practices, most of the antibiotics we include are in the World Health Organization’s List of Essential Medications. They further categorize antibiotics into ACCESS, WATCH, and RESERVE groups. Generally, antibiotics in the ACCESS group are more often available as oral formulations (nearly 60% of them), while this percentage is lower in the two other groups. 40% of WATCH antibiotics have oral formulations; the number is only 10% in the RESERVE group. This program is called the AWaRe Categorization. The AWaRe categorization illustrates which are the preferred antibiotic options for each syndrome, balancing benefits, harms and the potential for resistance. In 2017 WHO reviewed twenty one common infective syndromes, and selected the most appropriate first and second-choice antibiotic choices for each of the syndromes. The 2019 revision of the EML contains 37 antibiotics that are considered essential in treating 26 common and severe clinical infections, focusing on low-income and middle-income settings. The antibiotics were categorized following the AWaRe principles. 

The Essential Medications List, or EML, is a comprehensive, freely accessible, online database containing information on essential medicines. The eEML combines detailed medicine information (e.g. pharmaceutical) data with comprehensive evaluation of benefits, harms and costs (e.g. effectiveness, safety, implications for health care systems) information. Most importantly the eEML provides the data related to the status of a medicine as an essential medicine. Because of its well-defined scope, identifying those medicines that everyone should have access to at all times, and that all governments should ensure are available – and affordable – to their populations, the eEML provides a blueprint on which countries can base their own national lists. It is a key tool for achieving universal health coverage.
Furthermore the eEML is widely used by pharmacists, physicians, health professionals, students and the general public to identify those medicines that make a difference.

eEML is offered to the public as a freely available resource. eEML contents are available under the Creative Commons Attribution CC BY 3.0 IGO.

Furthermore, on the topic of antibiotic resistance, there is much work to be done in determining the relative contribution of varying practices in the medical community, the farming community, and to educate the general public on the most recent data so that they can collectively move towards better and safer world with less risk for multi-drug resistant infections. One systematic review of available literature on the topic of exploring the effect of restricted use of antibiotics on food-producing animals suggests that limiting consumption of these animals could reduce the prevalence of antibiotic-resistant bacteria in humans by 24%. There are many published reviews of outpatient antibiotic prescribing practices in humans, which estimate anywhere from 23% to 46% of antibiotic prescriptions are unnecessary. This includes medical offices, urgent cares, and emergency departments. Specifically for upper respiratory tract infections, it is estimated that half of all prescriptions are non-beneficial. Not only does this contribute to bacterial resistance to available treatments, but it increases the risk of adverse events from medication without a solid benefit to justify the treatments being given. About 24% of all medication adverse effects resulting in emergency room visits or admission into the hospital are from antibiotics. The most prolific antibiotic prescribers are urgent care centers, followed by retail clinics.