Can you get over-the-counter antibiotics?

In this article:

• Can you get antibiotics over the counter?
• OTC topical antibiotics and alternatives
• Natural remedies
• Prescription antibiotics

In this article

• Can you get antibiotics over the counter?
• OTC topical antibiotics and alternatives
• Natural remedies
• Prescription antibiotics

Antibiotics are medications that healthcare professionals prescribe to treat and prevent bacterial infections, such as strep throat, urinary tract infections (UTIs), skin infections, and sexually transmitted infections (STIs). The medications work by killing bacteria or hindering their growth and multiplication, allowing your body’s immune system to clear the infection effectively. Antibiotics cannot treat viral or fungal infections. Injectable or oral antibiotics require a prescription, but some topical treatments are available over-the-counter.

Can you get antibiotics over the counter?

Systemic antibiotics, which are taken by mouth or given as an injection by a healthcare provider, are prescription-only in the United States. There are a few reasons why. One reason is the need for a proper diagnosis from a healthcare provider. “[Antibiotics] require proper diagnosis to ensure the infection is actually bacterial rather than viral, and appropriate selection based on the specific pathogen and patient factors like allergies and kidney function,” says Walter Gaman, MD, DABFM, FAAFP, a family medicine physician and the founding partner of Executive Medicine of Texas in Southlake, Texas. 

Another factor is the potential for misuse or overuse of antibiotics. Chrissie Ott, MD, a dual board-certified integrative pediatrician and internist and founder and CEO of Joy Point Solutions in Portland, Oregon, says that patients need a healthcare provider’s guidance in making treatment decisions regarding the use of antibiotics. “ If non-clinicians were able to get antibiotics, we would have many incidences of viral respiratory infections treated with antibiotics, and we would see an increase in antibiotic-resistant infections,” she explains. “There would also be legitimate concern for symptoms being treated without adequate evaluation, delaying needed diagnosis and care.”

The U.S. Food and Drug Administration (FDA) helps regulate the use of antibiotics in both humans and animals to minimize the spread of antibiotic resistance, which has become a growing public health concern. The agency states that while antibiotics are powerful drugs, they’re not a cure for all diseases. They strongly advise against their use for viral infections, such as the common cold, influenza (also known as the flu), and most sore throats, as they’re ineffective and further contribute to antibiotic resistance.

Healthcare providers play a crucial role in reducing the spread of oral antibiotic resistance by conducting proper assessments, providing effective treatments, and educating patients. “As physicians, we must weigh the benefits against risks for each patient, considering their medical history, current medications, and the likelihood that an antibiotic will actually help their condition,” Dr. Gaman says.

It’s important to note that if antibiotics are deemed necessary to treat your condition, only a clinician can prescribe them. “In most states, pharmacists cannot independently prescribe antibiotics, though some states have expanded pharmacist prescribing authority for specific conditions like urinary tract infections or strep throat through collaborative practice agreements with physicians,” Dr. Gaman explains. “However, pharmacists play a crucial role in antibiotic stewardship by counseling patients on proper use, identifying potential drug interactions, and consulting with physicians when they have concerns about prescribed regimens.

While injectable and oral antibiotics aren’t available over the counter at your local pharmacy or convenience store, there are topical treatments and natural alternatives that may help with certain conditions.

OTC topical antibiotics and alternatives 

Although Dr. Gaman states that there are no over-the-counter medications that can truly substitute for injectable or oral antibiotics in treating bacterial infections, several options are available to support immune function and manage symptoms.

Below are a few over-the-counter topical antibiotics that may be suitable to treat some conditions:

Antibiotic ointments

Some topical antibiotic ointments, creams, and drops are available over the counter and can help treat certain infections. 

There are three main categories of topical antibiotics:

• Dermal (skin infections)
• Ophthalmic (eye infections)
• Otic (ear infections)

Examples of topical antibiotics you can purchase without a prescription include:

• Neosporin (bacitracin, neomycin, and polymyxin B)
• Polysporin (bacitracin and polymyxin)
• Bacitracin 

When it comes to skin infections, research shows that, in some cases, applying medication directly to an infected area can be as or more effective than systemic (oral or injected) administration, as topical antibiotics allow for the absorption of higher concentrations.

Additionally, some healthcare providers may recommend non-antibiotic treatments such as topical petroleum jelly instead of topical antibiotics after minor skin surgery, for example. Topical antibiotics aren’t always needed, and non-antibiotic treatments often have a lower risk of adverse effects, such as allergic reactions.

It’s important to note that while OTC topical antibiotics can be effective for certain conditions, if your infection gets worse, you experience side effects, or the infection returns after completing treatment, you should consult your healthcare provider for guidance on stronger treatment. 

Natural remedies 

There are a few natural compounds that contain properties similar to antibiotics. “Natural antimicrobial compounds like honey, garlic, and echinacea may provide some immune support, though their effectiveness is limited and they should never replace proper antibiotic treatment for serious bacterial infections,” Dr. Gaman says. 

There’s not a lot of evidence on natural treatments for infections. But here are a few natural remedies that may have some antibiotic properties, or help to support the immune system:

• Ginger: There are some studies that suggest ginger can obstruct various types of bacteria. However, most of these studies were done in a lab, and not with humans.
• Honey: Research shows that honey contains various antibacterial and antimicrobial components.. Honey is sometimes used on the skin to help with wound healing.
• Garlic: Garlic may have antibiotic properties against a variety of bacteria, including multidrug-resistant bacteria.
• Echinacea: Echinacea (also known as coneflower) may have antibacterial usefulness as a mouthwash and to clear mild respiratory infections more quickly.
• Clove: In laboratory tests, clove extract showed antibiotic activity against some bacteria that cause UTIs.
• Oregano: The compound carvacrol in oregano may possess some antimicrobial properties. One use that has been studied is as an agent against Streptococcus mutans, which may be involved in tooth decay.

While natural substances with antibiotic properties exist, Dr. Ott agrees with Dr. Gaman that they are not a replacement for prescription antibiotics. “When people ask me about over-the-counter alternatives to antibiotics, I’m honest: if it’s a real bacterial infection that needs treatment, there’s no substitute,” she says. “Some folks turn to immune-boosting supplements—things like various mushroom species, goldenseal, and others, and while those aren’t antibiotics, they may help the body resist infection. I’ve also seen supplements like D-Mannose used to help prevent bacteria from attaching to the urinary tract, which can lower the chances of getting a UTI.”

Prescription antibiotics 

All systemic antibiotics—those taken by mouth or injection—must be prescribed by a licensed healthcare provider, as these drugs have a higher chance of side effects and misuse. 

Some of the antibiotics that may be prescribed for common conditions include:

• Amoxicillin: A penicillin antibiotic used for bacterial infections in the ear, nose, throat, and urinary system.
• Azithromycin: Often prescribed for a variety of bacterial respiratory, middle ear, and skin infections.
• Ciprofloxacin: Used in the treatment of bacterial infections of the skin, bone, joint, lungs, sinuses, and bladder.
• Doxycycline: A tetracycline antibiotic commonly used for the treatment of bacterial infections, acne, and parasitic infections.
• Cephalexin: A cephalosporin antibiotic used to treat skin and soft tissue infections.

A healthcare provider will know how to prescribe an antibiotic that works for a particular type of infection. They can also be helpful if an antibiotic needs to be changed. “When patients have antibiotic allergies or resistance, I may prescribe alternative classes of antibiotics that work through different mechanisms—for example, switching from penicillin to macrolides, cephalosporins, or fluoroquinolones depending on the infection and patient factors,” Dr. Gaman says. 

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Dangers of using antibiotics without a prescription

There are several risks associated with taking leftover antibiotics, buying them online without a prescription from a provider, or self-diagnosing your medical conditions.

According to Dr. Gaman, the dangers of taking antibiotics that weren’t prescribed to you include:

• Development of antibiotic resistance
• Delayed proper assessment and treatment
• Incorrect dosages that may be ineffective or toxic
• Severe allergic reactions
• Drug interactions with other prescription medications
• Disruption of normal gut bacteria that leads to secondary bacterial infections

Before starting any antibiotic, consult your healthcare provider for medical advice to reduce your risk of potentially life-threatening side effects.