Online-only pharmacies that don't require prescriptions could be helping to fuel antibiotic resistance, finds study

Antimicrobial resistance is one the biggest threats to global health, food security, and development today, according to the World Health Organization (WHO).

Scientists have found that antibiotics are illegally available without prescription on 45 per cent of online pharmacy websites surveyed.

The researchers from Imperial College London analysed 20 pharmacies that were available for UK citizens to access online. This is one of the few studies to have examined the online availability of antibiotics and to have explored the potential effects on public health. The research is published in Journal of Antimicrobial Chemotherapy.

Antibiotics are classed as prescription only medicines in the UK, meaning they cannot legally be sold to consumers without a valid prescription. In the study, the researchers found that although online versions of UK high street pharmacies were compliant with prescription regulations, 80 per cent of the online pharmacies surveyed let customers choose their dosages, the duration and choice of antibiotic treatments. This can lead to serious side effects in patients and increases the risk of antimicrobial resistance.

Antimicrobial resistance is one the biggest threats to global health, food security, and development today, according to the World Health Organization (WHO). The study was carried out by academics from Imperial College London's NIHR Health Protection Research Unit for Healthcare Associated Infections and Antimicrobial Resistance, and Imperial College Healthcare NHS Trust.

The team carried out their research by entering the search term 'buy antibiotics online' into Google and Yahoo. The team recognise that the study is a 'snapshot' of the online pharmacy industry, but it does provide insights into how it operates. The 20 pharmacies at the top of the search were analysed by the team.

Dr Sara Boyd, a co-author and NIHR Academic Clinical Fellow in Infectious Diseases and Microbiology at Imperial, said: "These findings are a real concern, and raise several important issues regarding antibiotic resistance and patient safety with online pharmacies."

All online medicine vendors selling to UK consumers must by law register with both the Medicines and Healthcare products Regulatory Agency (MHRA) and the General Pharmaceutical Council (or the Pharmaceutical Society of Northern Ireland). However, the researchers found that 75 per cent of online pharmacies included in the study lacked evidence of the appropriate registration status required by law.

In other findings, the researchers discovered that 45 per cent of the online pharmacies analysed did not require a prescription from the patient.

Only 30 per cent of websites in the survey asked consumers to complete a health questionnaire prior to purchase.

Seventy per cent of the websites provided information on the safe usage of prescription medications, including potential side effects or adverse reactions when combined with other drugs.

Professor Alison Holmes, of Imperial's Department of Medicine, added: "Improper use of antibiotics can mean that infections are not being treated appropriately, or that people are being unnecessarily exposed to antibiotics. This allows bacteria to become resistant to drugs that once killed them. As a result, it is essential that antibiotics are prescribed only when they are needed."

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