What are the antibiotics on the $4 Walmart list?

Walmart $4 Prescription List Antibiotics

Walmart's $4 prescription list includes amoxicillin, penicillin VK, ciprofloxacin, doxycycline, sulfamethoxazole-trimethoprim (SMX-TMP), and metronidazole as the primary antibiotics available at this price point.

Available Antibiotics on Walmart's $4 List

The antibiotics commonly available on Walmart's $4 prescription program include:

• Amoxicillin - Available in multiple formulations:

  • 250mg capsules
  • 500mg capsules
  • 125mg/5mL suspension
  • 250mg/5mL suspension

• Penicillin VK - Available as:

  • 250mg tablets
  • 500mg tablets

• Ciprofloxacin - Available as:

  • 250mg tablets
  • 500mg tablets

• Doxycycline hyclate/monohydrate - Available as:

  • 50mg capsules
  • 100mg capsules

• Sulfamethoxazole-Trimethoprim (SMX-TMP) - Available as:

  • 400mg-80mg tablets (single strength)
  • 800mg-160mg tablets (double strength)

• Metronidazole - Available as:

  • 250mg tablets
  • 500mg tablets

Clinical Applications of These Antibiotics

Amoxicillin

• First-line treatment for mild skin and soft tissue infections 1
• Effective for Haemophilus influenzae infections (beta-lactamase negative) 1
• Common dosing: 250-500mg three times daily

Penicillin VK

• Treatment for Streptococcus infections
• Commonly used for pharyngitis, skin infections
• Standard dosing: 250-500mg four times daily

Ciprofloxacin

• Used for urinary tract infections, respiratory infections
• Alternative for Haemophilus influenzae (beta-lactamase positive) 1
• Dosing: 250-500mg twice daily

Doxycycline

• First-line for Mycoplasma pneumoniae infections 1
• Effective for skin and soft tissue infections
• Dosing: 100mg twice daily for 7-14 days 2

Sulfamethoxazole-Trimethoprim

• Alternative for MRSA skin infections 1
• Used for urinary tract infections
• Dosing: 1-2 double-strength tablets twice daily

Metronidazole

• Treatment for anaerobic infections 2
• Often used in combination therapy
• Dosing: 300-450mg three times daily

Important Considerations and Limitations

1. Resistance Patterns: Local resistance patterns may affect efficacy of these antibiotics, particularly for ciprofloxacin and SMX-TMP.

2. Contraindications:

   • Fluoroquinolones (ciprofloxacin) are generally contraindicated in children under 18 and pregnant women 2
   • Tetracyclines (doxycycline) are contraindicated in pregnancy and children under 8 years 2

3. Limited Spectrum: The $4 list does not include:

   • Newer generation cephalosporins
   • Macrolides like azithromycin
   • Beta-lactamase inhibitor combinations (except potentially amoxicillin-clavulanate at higher price points)
   • Vancomycin or other antibiotics for resistant organisms

4. Quantity Limitations: The $4 pricing typically applies to a 30-day supply with specific quantity limitations.

Common Pitfalls to Avoid

1. Inappropriate Selection: Choosing an antibiotic based on price rather than appropriate spectrum of activity for the suspected pathogen.

2. Inadequate Duration: Not completing the full prescribed course of antibiotics, which may lead to treatment failure and resistance.

3. Self-medication: Patients may attempt to self-medicate with leftover antibiotics due to their affordability, which should be strongly discouraged.

4. Resistance Concerns: Overuse of these accessible antibiotics may contribute to antimicrobial resistance.

Remember that while these antibiotics are cost-effective options, prescription and appropriate clinical assessment are still required for their dispensing and use. The selection should be based on the specific infection, suspected pathogen, local resistance patterns, and patient factors rather than cost alone.