Antibiotics are a class of medication used for the treatment of bacterial infections. If you’ve ever had an ear infection, a UTI or strep throat, chances are you’ve been prescribed an antibiotic to combat your illness. Antibiotic drugs can be given in a variety of forms and with various strengths. In general, bacterial infections require prescription medication for complete treatment. There are no FDA-approved oral antibiotics available to be purchased over the counter. While over-the-counter (OTC) antibiotic options are limited in the U.S., some antibacterial medicines are available for purchase without a prescription.

So, what’s the difference between prescription and OTC antibiotic medicines? Before starting any sort of treatment, you seek medical advice from a health care provider to determine the best treatment option for you. We’ve put together a cheat sheet to help clarify what these medications are, what they’re used to treat and how they are supplied. Refer to this information to better understand your treatment plan and the medication you are using.

What Are Antibiotics Used For?

Antibiotic medication is used for the treatment of bacterial infections. Infections from harmful bacteria can cause many dangerous medical conditions. These infections can affect various parts of the body in diverse ways.

Some of the most common bacterial infections include:

- Food poisoning
- Bacterial pneumonia
- Skin infections such as impetigo, boils and cellulitis
- Ear (Otitis media) and sinus infections
- Urinary tract infections (UTIs)
- Sexually transmitted infections such as chlamydia and gonorrhea
- Strep throat
- E. coli infections
- Bacterial vaginosis (bacterial overgrowth in the vagina)
- Lyme disease

Antibiotics are used only for the treatment of bacterial infections. They cannot be used to treat viral infections like the common cold, COVID-19 and the flu.

Bacterial infections can be spread via airborne droplets, direct or indirect skin contact, bug bites and contaminated surfaces or food. This is not a complete list, but these are among the most common means of transmission.

What are the most commonly prescribed antibiotics?

Antibiotic medication is supplied in a wide variety of forms and strengths. There are four primary routes of administration for an antibiotic medication. The specific form or method the drug is supplied depends on the patient and the condition being treated.

The four common types of antibiotic medication are:

- Oral antibiotics (usually capsules, tablets, or a liquid solution)
- Topical antibiotics (usually gels, creams, or ointments to be applied to the affected area)
- Intravenous antibiotics (administered in a health care setting like a doctor’s office or hospital)
- Intramuscular injection (also usually administered in an outpatient setting like a doctor’s office or hospital)

The ten most common antibiotic prescription drugs ordered by providers on Sesame are:

- Azithromycin
- Penicillin
- Amoxicillin
- Metronidazole
- Levofloxacin
- Nitrofurantoin
- Ciprofloxacin
- Cefdinir
- Clindamycin
- Cefalexin

These drugs are used to treat a wide variety of bacterial infections. For instance, you may be prescribed topical azithromycin eye drops as a treatment for a bacterial eye infection or oral azithromycin for bronchitis. The form of medication prescribed will depend on the infection.

Intravenous and intramuscular antibiotic injections are used for severe infections like sepsis. These injections are fast-acting and highly concentrated. Because of their strength, they are applied by a licensed health care provider in a health care setting.

Your Options for Over-the-Counter Antibiotics

The FDA has not approved any oral or injectable antibiotic medication for over-the-counter purchase. In other words, oral, intravenous and intramuscular antibiotic medications are only available via prescription from a licensed health care provider. Many formulations of topical medication also require a prescription for use. However, there are several over-the-counter topical antibacterial medications widely available.

Topical antibiotics are supplied as gels, ointments, creams, sprays or powders. These are often used to treat minor cuts, scrapes, burns and acne.

Common brand-name topical OTC antibiotic medications include:

- Neosporin (bacitracin/neomycin/polymyxin B)
- Polysporin (bacitracin/polymyxin B)
- Proactiv (benzoyl peroxide)

Generic versions of these medications are also widely available, often at a lower cost than the brand name option. These topical drugs should be applied directly to the affected area. They are only approved for external use and should not be ingested in any way.

Even though the medication above is widely available in pharmacies and health care aisles, we still recommend that you seek medical advice from a health care provider before using OTC antibiotics for treatment – as many of these have been found to cause more irritation and harm than they are helpful. You probably don’t need to speak to a doctor before you put Neosporin on a cut, but deeper wounds, moderate burns and skin infections–even acne–should be looked at by a medical professional before OTC antibiotic use. Some conditions require advanced treatment that necessitates prescription medication. Additionally, OTC antibiotic medication can cause side effects such as skin irritation. Talking to a health care provider before any medication usage can reduce your risk of adverse reactions and help you get the best results from your treatment.

How do I know if I need OTC or prescription antibiotics?

OTC antibiotics are only used topically, meaning they should only be used externally. This can help treat minor afflictions such as cuts, scrapes and mild acne. Prescription topical medication is used for more severe cases of skin infections and acne. Oral antibiotics are prescribed for bacterial infections that occur inside the body such as strep throat, UTIs and sinus infections.

Not sure what treatment plan is right for you? Talk to a health care provider on Sesame to get fast and affordable care for your condition. Telehealth visits are more cost-effective and convenient than in-person urgent care visits, and providers on Sesame can prescribe antibiotic medication when appropriate. During these visits, you can discuss your symptoms, treatment options and proper medication usage with a licensed medical professional. These appointments are valuable even for minor problems like mild wounds, as they offer a low-cost means of getting medical advice without the hassle of getting to a clinic.

Book a telehealth appointment on Sesame for any primary care or urgent care needs to get treatment right away at a fraction of the price you’d pay for an in-person doctor’s visit.

Why do Antibiotics Require a Prescription?

Antibiotics are often the first line of treatment for bacterial infections. The medicinal benefits of antibiotics far outweigh the risks involved with their use, but they are potent drugs that can affect the body in various ways.

Overusing oral antibiotics can not only cause harmful side effects from overdose but can also contribute to antibiotic resistance. This means that the invasive bacteria become resistant to antibiotic treatment, eventually rendering them useless for everyone. This risk is reduced by having dosage formulated by a licensed health care provider. Medical professionals receive specific training to know when antibiotic medication is needed, and what dosage is most effective in fighting a given condition.

Overuse of antibiotics can also affect the microbiome of your body. A microbiome is a complex collection of bacteria that live in your body. This collection consists of “good” bacteria that actually protect your body against the overgrowth of harmful bacteria while playing a key role in digestion and general wellness. Antibiotics kill without regard for “good” bacteria or bad, , making it more likely that harmful bacteria overpopulate and infect your body.

If you have been prescribed an antibiotic, take it exactly as ordered by your provider. Do not increase your dosage without speaking to them first. Continue to take the full course of treatment, even if you begin to feel better. Bacteria can regenerate and reinfect the body if not adequately treated. Take the entirety of your prescription according to the directions of the prescriber.

Similarly, different antibiotics work on different bacteria. Azithromycin, for instance, is used for the treatment of STIs such as chlamydia and gonorrhea. It is not prescribed to treat strep throat, as it is less effective against that particular bacteria than other antibiotic drugs. Amoxicillin, on the other hand, is effective as a treatment for strep throat but is not considered an effective treatment for sexually-transmitted bacterial infections. Making these drugs only available via prescription reduces the risk that a patient will take the wrong antibiotic for their condition.

Finally, antibiotics can interact with other medications and substances in the body. This can cause a negative reaction and potentially severe side effects. When a doctor orders an antibiotic prescription, they will also take charge of monitoring any possible adverse reactions to the drug. Before starting treatment with antibiotic medication, let your health care provider know about any medical conditions you are currently managing, as well as any medication or supplements you are taking. If you have experienced an allergic reaction to antibiotic medication, you should let them know that as well.

In addition, let your doctor know if you are planning to become pregnant, are pregnant, or are currently breastfeeding before starting treatment with antibiotic medication. Call your provider if you become pregnant while you are taking antibiotics.

References

• CDC.gov: Antibiotic Do’s and Don’ts
  

• Food and Drug Administration (FDA): Antibiotics and Antibiotic Resistance
  

• Medline Plus: Antibiotics