A case report of self-medication with over-the-counter fish antibiotic: Implications for pharmacists.

OBJECTIVE: The human use of over-the-counter antibiotics intended for the treatment of pet animals has been recognized as a potential barrier to antibiotic stewardship efforts. The objective of this report is to describe a case of self-medication with a fish antibiotic resulting in delayed medical treatment and provide recommendations for pharmacists practicing in outpatient settings on how to best identify and manage nonprescription antibiotic use. CASE SUMMARY: A 24-year-old man experienced dental pain and "flu-like" symptoms for which he attempted self-treatment with oral amoxicillin 250 mg daily purchased by a family member from a pet store. The amoxicillin was marketed for the treatment of bacterial infection in pet fish. After several days of increasing tooth pain despite the self-medication, the patient presented to an outpatient clinic where he was found to have a molar abscess requiring tooth extraction. The patient responded well to therapy and was counseled to discontinue antibiotic self-treatment. PRACTICE IMPLICATIONS: Undocumented use of nonprescription antibiotics represents a threat to patient safety. Potential deleterious outcomes include resistance, adverse drug events, and delays in definitive infection treatment. Pharmacists should screen patients for nonprescription antibiotic use, provide them counseling on appropriate antibiotic use, and educate other health care professionals on underrecognized sources of nonprescription antibiotics to increase awareness of this growing issue. Furthermore, antibiotic resistance should be considered when recommending an antibiotic agent for the treatment of infections.

Dentists' Perceptions of Their Peer Learning Experiences in Dental School and Effects on Practice.

Peer-assisted learning (PAL) has been found in medical, nursing, and dental education research to aid in preparing students to develop clinical judgment, leadership, and teamwork skills. This study sought to extend that research by assessing the effect of PAL on dentists in practice. The aim of this study was to ask practicing dentists who were clinically trained with PAL in dental school for their perceptions of the effects and value of that training for their patient care, team relations, and professional development. In addition, participants were asked for recommendations to improve pairing and the matching process. An electronic survey was sent in October 2017 to all 667 dentists who graduated from Midwestern University College of Dental Medicine-Arizona from 2012 to 2017, all of whom had been trained in a PAL-general practice model. A total 107 alumni responded, for a 16% overall response rate; the response rate averaged 16.7% for each class. The majority (83.6%) of responding dentists recommended peer learning in clinical dental education. Survey participants attributed their clinical judgment (72.3%) and teamwork (80.9%) skills to peer pairing in dental school. Among the respondents, 89.8% had taken leadership roles and were training team members, and 75.7% reported enjoying teaching others. Of the 65% who commented on peer pairing enhancements, 15% recommended rotation of peers for greater learning experiences, and 24% advised personality assessments for future pair matching. These results suggested that participating in PAL had helped prepare these alumni for practice.