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Care"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>Non-prescription antibiotic use (using antibiotics without medical advice) is potentially unsafe and promotes antimicrobial resistance. We studied predictors of prior non-prescription use and whether screening for prior non-prescription antibiotic use predicted intention of future non-prescription antibiotic use.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>The survey was performed from January 2020 - June 2021 in six public primary care clinics and two private emergency departments. Prior non-prescription users were respondents who reported taking oral antibiotics for symptoms without contacting a clinician. Intended use was defined by answering yes to the question, \u201c<jats:italic>would you use antibiotics without contacting a doctor\/nurse\/dentist\/clinic<\/jats:italic>.\u201d We examined predictors for prior non-prescription use. We also calculated the sensitivity, specificity, and positive and negative predictive value (PPV, NPV) of (a) any prior non-prescription antibiotic use and (b) prior use in the past 12 months - for future intended non-prescription use.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of 564 survey respondents, 246 (43.6%) reported non-prescription use; 91 (37.0%) of these respondents, 16.1% overall, reported doing so in the past 12 months. Approximately 63% of non-prescription antibiotic use was in those with a previous prescription of the same antibiotic for similar symptoms\/illnesses. The screening characteristics of non-prescription use in the past 12 months to identify intention to use of antibiotics without a prescription in the future were: sensitivity 75.9% (95% CI: 65.3\u201384.6), specificity 91.4% (95% CI: 87.8\u201394.2), Bayes\u2019 PPV 74.5% (95% CI: 66.7\u201380.9), and Bayes\u2019 NPV 93.7% (95% CI: 90.5\u201396.1).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>This study proposed a method to screen for future use of non-prescription antibiotics, which may have implications on antimicrobial stewardship efforts in primary care settings.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12875-025-02811-3","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T10:56:27Z","timestamp":1744714587000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A screening question to assess risk of using antibiotics without a prescription: a diagnostic study"],"prefix":"10.1186","volume":"26","author":[{"given":"Ashley","family":"Collazo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Amenta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiara","family":"Olmeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marissa","family":"Valentine-King","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Laytner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azalia","family":"Mancera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Zoorob","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael K.","family":"Paasche-Orlow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard L.","family":"Street Jr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara W.","family":"Trautner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa","family":"Grigoryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,15]]},"reference":[{"issue":"9","key":"2811_CR1","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1016\/S1473-3099(11)70054-8","volume":"11","author":"DJ Morgan","year":"2011","unstructured":"Morgan DJ, Okeke IN, Laxminarayan R, Perencevich EN, Weisenberg S. 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Informed consent was obtained from all participants in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"This work is the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality or the United States Government.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"111"}}