Nonprescribed Antimicrobial Drugs in Latino Community, South Carolina Arch G. Mainous III,* Andrew Y. Cheng,* Rebecca C. Garr,* Barbara C. Tilley,* Charles J. Everett,* and M. Diane McKee† We investigated in a sample of Latinos the practices of antimicrobial drug importation and use of nonprescribed antimicrobial drugs. In interviews conducted with 219 adults, we assessed health beliefs and past and present behaviors consistent with acquiring antimicrobial drugs without a prescription in the United States. Many (30.6%) believed that antimicrobial drugs should be available in the United States without a prescription. Furthermore, 16.4% had transported nonprescribed antimicrobial drugs into the United States, and 19.2% had acquired antimicrobial agents in the United States without a prescription. A step- wise logistic regression analysis showed that the best pre- dictors of having acquired nonprescribed antimicrobial drugs in the United States were beliefs and behavior con- sistent with limited regulations on such drugs. Many per- sons within the Latino community self-medicate with antimicrobial drugs obtained without a prescription both inside and outside the United States, which adds to the reservoir of antimicrobial drugs in the United States. Tmunity is directly related to the amount of antimicro- he amount of antimicrobial drugs consumed in a com- bial drug resistance found in the community (1,2). Inappropriate use of antimicrobial drugs, particularly for respiratory infections, has contributed to the major public health problem of antimicrobial resistance. Interventions in the United States have decreased inappropriate antimi- crobial drug prescribing in general and for respiratory infections in particular (3–5). In many nonindustrialized countries, antimicrobial resistance is an even greater problem than it is in the United States; however, many of these countries have few *Medical University of South Carolina, Charleston, South Carolina, USA; and †Albert Einstein College of Medicine, Bronx, New York, USA restrictions on the sale of antimicrobial agents, or laws are unevenly enforced (6–9). The dispensation of antimicro- bial drugs without a prescription is particularly problemat- ic in Latin America (9,10). Persons in countries with few regulations on antimicrobial agents tend to have cultural norms that encompass self-diagnosis and buying of antimi- crobial drugs in subtherapeutic quantities (8,10,11). More than 320 million persons cross the border into the United States each year from Latin American countries where antimicrobial drugs are available without a prescription (12). Health beliefs and practices are integrated into one’s ethnic and cultural orientation (13–15). Limited evidence indicates that even after moving to the United States, per- sons from countries with limited or no restrictions on antimicrobial drugs are more likely than persons born in the United States to use them for inappropriate indications, such as common colds, and use them without a prescrip- tion (16,17). Initiatives to increase judicious use of antimicrobial drugs to address antimicrobial resistance have focused pri- marily on changing prescribing patterns of US physicians and have failed to account for antimicrobial drug importa- tion and concomitant inappropriate self-medication within immigrant communities. The pool of nonprescribed antimicrobial drugs entering the United States is currently unknown as is the extent of acquisition of nonprescribed antimicrobial drugs within communities whose health beliefs and practices may be inconsistent with those of the US public health community. Thus, the purpose of this study was to investigate a sample of Latinos living in the United States in terms of their practices of antimicrobial drug importation and acquisition and use of nonprescribed antimicrobial drugs. Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 11, No. 6, June 2005 883