In the Washington, D. C. area the supermarket chain Giant Food stores has been offering free antibiotics to its customers. It’s part of an effort to wrest back market share from competitors. “Giant pharmacies are committed to improving the health and wellness in our communities during the winter season when families are susceptible to coughs, colds, and bacteria-borne illnesses,” said Andrea Astrachan, consumer advisor for Giant Food in a statement at the end of December announcing the launch of the program. Giant is not alone. Wegmans, ShopRite, Stop and Shop, and others have similar give-a-ways and that’s a concern to a group of infectious disease specialists who fear these promotions my do more harm than good.

One concern among healthcare professionals fighting infectious diseases is that some of these stores are linking the promotion to cold and flu season, despite the fact that antibiotics do not work against these viral illnesses. Furthermore, antibiotics can have serious side effects, and their misuse is contributing to the increase in antibiotic-resistant infections such as methicillin-resistant Staphylococcus aureus or MRSA. As influenza season shifts into high gear, with 24 states now reporting widespread activity, the Infectious Diseases Society of America and the Centers for Disease Control and Prevention as influenza are urging supermarket pharmacies with free-antibiotics promotions to educate their customers on when antibiotics are the right prescription.

"Taking an antibiotic when you don't need it won't help you, and may in fact do more harm than good," says Infectious Diseases Society of America President Anne Gershon. "At a time when antibiotic overuse is helping to create drug-resistant superbugs such as MRSA and few new antibiotics are being developed, supermarkets need to be responsible in how they promote antibiotics."

Gershon’s organization along with the Centers for Disease Control and Prevention have written to supermarkets with free-antibiotics promotions asking them to join "Get Smart: Know When Antibiotics Work," a campaign from CDC to educate consumers about the importance of using antibiotics appropriately.

Studies show many people believe that antibiotics can cure a cold or the flu, and tend to ask or pressure their clinicians to provide them. Every year, tens of thousands of people are prescribed antibiotics for these conditions, even though they will do no good and can be harmful. A recent study in Clinical Infectious Diseases estimates that antibiotics are responsible for 142,000 emergency department visits each year, mostly because of allergic reactions.

"Supermarkets have the power to protect their customers' health," said Lauri Hicks, DO, medical director of CDC's "Get Smart" program. "If they sought to educate people about when antibiotics work and when they don't, they would be doing a great public service."

In letters to Wegmans, ShopRite, Stop and Shop, and Giant, IDSA and CDC suggest that supermarkets could begin with CDC's easy-to-understand posters, brochures, and other educational materials. Jamie Miller, public affairs manager for Giant Food, said he was not aware of his company receiving the letter, but defended the supermarket’s policy as one that helped customers during an economically challenging time.

“It’s really a public service we are offering our pharmacy customers who may be struggling during these difficult times,” says Miller. “Our position is that the doctors who prescribe antibiotics are the trained professionals and they are making decisions on what they feel is best for their customers and often times that is a prescription for an antibiotic and we are there to help out.” Miller said he was not familiar with the letter.

The Infectious Diseases Society of America suggests supermarkets offer free flu shots rather than free antibiotics as a way to save customers money while protecting their health. "As flu season heats up,” says the organization’s Gershon, “free influenza vaccinations would be a proven-effective way to keep customers healthy."