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Why do doctors never take test to check if it is viral or bacterial

(12 Posts)
literarygeek Thu 09-May-13 11:38:38

awkwardpingu

The rapid throat swabs can only test for one thing at a time. See www.m.webmd.com/oral-health/rapid-strep-test-for-strep-throat

For example strep. A proper culture can test for any bacteria.

Similarly, the finger prick test can be used for rapid serology (ELISA type testing) for certain bugs. That's how come you can have rapid hiv or h pylori tests.

Or finger pricks might have been used to check inflammatory markers like Crp. Which also doesn't tell you if it's bacterial or viral but might make you more worried I guess. I think that's not really helpful on its own.

Bottom line- open communication between parents and GPs is the way forward! Sounds like the OP's plan will be helpful.

lyndie Netherlands Thu 09-May-13 09:32:45

Yes but in America your medicine is private and its all charged back to your insurer at a phenomenal cost. They are also practising very defensively so do things to avoid getting sued rather than what is best for the patient. Here we use other measures like Centor criteria which is an evidence based way of working out who needs antibiotics - without fancy invasive tests for the sake of it!

claraschu Thu 09-May-13 09:21:31

In the US, children are routinely seen by paediatricians, who do a strep test (throat swab) for sore throats before prescribing. The results don't anything like 5 days.

misscph1973 Thu 09-May-13 09:10:49

Thanks, AwkwardPingu, nice to hear from a professional ;) although it is rather depressing to hear that medicine is not an exact science...

AwkwardPingu Wed 08-May-13 23:42:51

This is my first post. I am a final year medical student in London.

You describe an easy finger prick blood test? This does not exist, not here at least. If a bacterial infection has progressed to the blood stream then the patient is septicaemic. The patient is acutely unwell and cultures would be taken. Even then it takes at least 24 hrs for cultures to return depending on the organism.

Urine samples do not even test for bacteria, they test for changes in urine such as protein, blood and nitrites which can be associated with but not specific for a UTI.

Medicine, I can only speak for England, is mostly empiric. If it looks, walks and sounds like a horse, we assume it's a horse.

misscph1973 Wed 08-May-13 14:04:56

Thanks, Poledra, I have also done this on a few occasions with my dd and also my ds, so that is definitely a possibility next time. Hopefully with the warmer weather the next time will be a long time from now!

Poledra Wed 08-May-13 10:22:51

I have, with the agreement of my doctor, taken a prescription for antibiotics for one of my children with a suspected infection, and held onto the script for a few days to see if we need to fill it. This is especially useful for over a BH weekend. If the child worsens, then I'll fill the prescription and give them the medication. If they get better without it, I shred the script and that's the end of it. Might this be worth exploring with your GP?

misscph1973 Wed 08-May-13 10:15:07

Thanks, literarygeek. My GP has never suggested a swab or a sputum.

I am quite happy with my GP, and I had thought that perhaps he thinks I have come to get antibiotics ;)

I had already decided that next time he suggests antibiotics, I will ask if it is reasonable to wait and see before I give it. I don't normally go to the GP unless I am worried, but on all 4 occasions the illness started either right before a weekend or a bank holiday, and I do prefer to see my GP instead of waiting in the A&E.

literarygeek Wed 08-May-13 10:02:05

Not just cost. Lots of other things involved. Throat infection: a swab should always be done before giving antibiotics but it takes 5 days culture for a throat swab. You might be better by then anyway.
Cough: v hard to prove bacterial chest infection without sputum (hard to get from a kid!). Worried parent in front of them wanting a solution.

As i understand it, 'Instant' Blood tests are of limited use for certain infections.

I expect GPs who are under a lot of pressure think parents want to leave 'with something'. If you explain you'd rather avoid abx, just say so. They'll probably be pleased.

If not, get another GP. Or stay at home and give calpol unless you're really worried.

misscph1973 Tue 07-May-13 21:36:43

You are probably right, Sirzy. There is just always some scare in the news about antibiotics resistance, you would think tests were worth it.

Sirzy Tue 07-May-13 11:32:27

Cost probably the main reason.

Most things will be viral so it is often best to just sit and wait and then unless they are showing signs that something is bacterial or it isn't clearing then they generally won't give antibiotics.

misscph1973 Tue 07-May-13 11:30:03

My DD has been prescribed antibiotics 4 times since Christmas. The only time where a test was taken was last time, where it was a suspected urine infection. The test result took 5 days but the antibiotics were still prescribed. The test came back negative.

I am not best pleased that DD has been given so many courses of antibiotics in such a short time. I am of the opinion that antibiotics kill everything and thus eases the way for new infections and also I am worried about DD developing resistance to antibiotics.

My question is: Why do doctors never/rarely take any tests to decide if an infection is viral or bacterial? I am from Denmark where it is unheard of to give antibiotics without a positive test result. It is often a simple blood test taken from a drop of blood from a finger and result is available in a few minutes. It can also be a urine sample or a more complicated test but most often the test doesn't even need to be sent to a lab.

Why do the NHS not have a similar system? It's not like Denmark is a country that is considered more advanced than England.

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