RESEARCH practices in ethnic minority communities. Patient educa- tion materials should communicate in a culturally compe- tent way the dangers of self-medication and antimicrobial misuse to both recent immigrants and others in the Latino community. US health policies also may need to be revised, with consideration given to tightening regulations to reduce the presence of nonprescribed antimicrobial drugs and to increasing access to care for many Latinos. Acknowledgments We would like to thank Vanessa Diaz and Elaine Larson for their help with the questionnaire and Claire Campbell, Brian Giddens, and Eileen Yamada for their help with the initial con- ceptualization. This project was supported by grants 5 P01 HS010871 from the Agency for Healthcare Research and Quality, 5 P30 AG021677 from the National Institute on Aging, and 1D12HP00023-01 from the Health Resources and Services Administration. Dr. Mainous is a professor in the Department of Family Medicine at the Medical University of South Carolina. He has conducted a variety of studies on the overuse of antimicrobial drugs for respiratory infections focusing on such aspects as physician prescribing, how knowledge affects prescribing deci- sions, and colonization with resistant organisms. References 1. Austin DJ, Kristinsson KG, Anderson RM. The relationship between the volume of antimicrobial consumption in human communities and the frequency of resistance. Proc Natl Acad Sci USA. 1999;96: 1152–6. 2. Albrich WC, Monnet DL, Harbarth S. Antibiotic selection pressure and resistance in Streptococcus pneumoniae and Streptococcus pyo- genes. Emerg Infect Dis. 2004;10:514–7. 3. Mainous AG III, Hueston, WJ, Pearson WS, Davis MP. Trends in antimicrobial prescribing for bronchitis and upper respiratory infec- tions among adults and children. Am J Public Health. 2003;93:1910–4. 4. Finkelstein JA, Stille C, Nordin J, Davis R, Rae el MA, Roblin D, et al. Reduction in antibiotic use among US children, 1996–2000. Pediatrics. 2003;112:620–7. 5. Interagency Task Force on Antimicrobial Resistance. A public health action plan to combat antimicrobial resistance. Part 1: domestic issues. Washington: US Department of Health and Human Services; 2004. 6. Becker J, Drucker E, Enyong P, Marx P. Availability of injectable antimicrobial drugs in a town market in southwest Cameroon. Lancet Infect Dis. 2002;2:325–6. 7. Hsueh P-R, Luh K-T. Antimicrobial resistance in Streptococcus pneu- moniae, Taiwan. Emerg Infect Dis. 2002;8:1487–91. 8. Dua V, Kunin CM, White LV. The use of antimicrobial drugs in Nagpur, India. A window on medical care in a developing country. Soc Sci Med. 1994;38:717–24. 9. Drug Utilization Research Group, Latin America. Multicenter study on self-medication and self-prescription in six Latin American coun- tries. Clin Pharmacol Ther. 1997;61:488–93. 10. Calva J. Antibiotic use in a periurban community in Mexico: a house- hold and drugstore survey. Soc Sci Med. 1996;42:1121–8. 11. Lansang MA, Lucas-Aquino R, Tupasi TE, Mina VS, Salazar LS, Juban N, et al. Purchase of antibiotics without a prescription in Manila, The Philippines. Inappropriate choices and doses. J Clin Epidemiol. 1990;43:61–7. 12. Weinberg M, Waterman S, Lucas CA, Falcon VC, Morales PK, Lopez LA, et al. The U.S.-Mexico border infectious disease surveillance project: establishing bi-national border surveillance. Emerg Infect Dis. 2003;9:97–102. 13. Kleinman A, Eisenberg L, Good B. Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med. 1978;88:251–8. 14. Pachter LM. Culture and clinical care: folk illness beliefs and behav- iors and their implications for health care delivery. JAMA. 1994;271:690–4. 15. Fishman BM, Bobo L, Kosub K, Womeodu RJ. Cultural issues in serving minority populations: emphasis on Mexican Americans and African Americans. Am J Med Sci. 1993;306:160–6. 16. McKee MD, Mills L, Mainous AG III. Antibiotics for the treatment of upper respiratory infections in a diverse community. J Fam Pract. 1999;48:993–6. 17. Larson E, Lin SX, Gomez-Duarte C. Antibiotic use in Hispanic households, New York City. Emerg Infect Dis. 2003;9:1096–1102. Address for correspondence: Arch G. Mainous III, Department of Family Medicine, Medical University of South Carolina, 295 Calhoun St, Charleston, SC 29425, USA; fax: 843-792-3598; email: mainouag@ musc.edu 888 Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 11, No. 6, June 2005