To think a GP doesn't understand antibiotics

I can remember my Gp looking up a book before prescribing things, it's such a shame that people thing a trained medic is "googiling" !

IANAD, but GPs use online professional and official resources instead of hard copy books. Using google as a means to find the right website is inefficient but not illegal (and sometimes necessary if your computer has suddenly lost its mind - I presume GPs have the same issues as the NHS).

Unless of course they are googling research papers. Microfiches are a bit old hat these days and too big for the average GP surgery, and it’s often quite a long way to the nearest university library.

Or are you suggesting GPs should always operate from memory?

Gp looking online for advice 🤦‍♀️

Bacterial tonsillitis can be caused by viral tonsillitis

Most tonsillitis are viral. Centor criteria

https://www.mdcalc.com/calc/104/centor-score-modified-mcisaac-strep-pharyngitis

Is used to calculate how likely it is to be bacterial (strep) and that's used to determine whether its more likely bacterial. Some GPs will suggest a throat swab to check and watch and wait to see if self resolves, some give delayed abx scripts to take if lack of improvement, but if you score v highly on criteria then abx from outset

I'd not bother going to the GP again since you know more about it than her by using Dr Google. Obviously all those years in med school were a complete waste of time.

@FakePlanet - I think it was a very reasonable question on your part.

I'd be boggling at having to take 5 antibiotic pills spread throughout the day and on an empty stomach. It does seem a weird choice of antibiotics by the GP tbh (but I really don't actually know as I'm not a GP!)

I hope you are feeling better soon

What antibiotics you take 5x per day???

It wasn't an unreasonable question, and now lots of us understand more about how GPs handle these things, which can only be useful. Don't feel bad.

Tbh when I was healthcare I wouldn’t do a swab unless the most likely to work antibiotic failed. It’s not cheap to send a swab off and most of the time confirms you got it right anyway.

GPs don’t always need to do a swab (actually I’ve never heard of anyone getting one- presumably because the results take a while so it’s better for GP to make an assessment based on symptoms.)

My DH had tonsillitis a few years ago and the GP prescribed ABs without even seeing him. This was based on a phone consultation in which DH described the white sores in his throat, his fever and vomiting and the fact that he couldn’t stay awake for more than about 45 minutes at a time. It had got pretty bad because DH had assumed it was viral and would go on its own so didn’t seek help. It got much worse very quickly, at which point he called the surgery.

Thank you! I've got 14 days' worth by the looks of it.

Phenoxymethylpenicillin (catchy name)

It's also known as penicillin V, which is a bit catchier.

Also in the UK and never struggled to get what I need from the GP the same day. Not all surgeries are crap. Mine are fantastic.

Similar experience to Kyse ^^ - I'm also immunocompromised so there's a different protocol.

I'm currently on a ten day course of Phenoxymethylpenicillin (catchy name) as a prophylactic antibiotic, i.e. to prevent an infection taking hold as that could easily land me up in hospital.

The GP surgery were ruthlessly efficient about it - all happened on the same day I contacted them. (NHS, UK).

I'm in the U.K. and can. Usually a quick phone appointment where they go "yeah come down to the surgery in about 2hrs" and seen and prescribed
Immunocompromised and always get bacterial tonsillitis
Doctor once asked me why I thought I needed antibiotics so I just opened my mouth and watched him

Fair play, @FakePlanet.

Get well (and get some sleep!) soon

Here is the fever pain score tool they use. https://ctu1.phc.ox.ac.uk/feverpain/index.php

Gp will have prescribed based on your ‘fever pain score’. 10 days of abx for query strep/bacterial tonsillitis is reasonable. Hope you feel better soon.

^ and that’s me not having read the thread OP, no offence meant with my post. Was just relaying our experiences with tonsillitis and antibiotics. DD always looks like she’s in as much pain as you’ve prescribed, the antibiotics usually take more than a week for her to start feeling better but sucking on ice chips helps with fluid intake (she gets it bad enough it’s painful to swallow even water)

@FakePlanet Get well soon.

I think the title was a bit inflammatory and I came on to tell you to be quiet but can see you’ve realised the GP does understand antibiotics.

Tonsillitis is awful so take those tablets and go back if no improvement

DD gets repeat bacterial tonsillitis, usually with severely inflamed tonsils and white spots covering them. She doesn’t get tested for bacterial because the GP can see it with her own eyes. GP also always reviews the current guidelines for antibiotics with bacterial tonsillitis because guidelines change all the time and her workload is high enough she doesn’t have the time to keep up with constantly changing guidelines so it’s always better for her to double check.

Quite. Why are people continuing to kick OP when she’s already agreed she’s wrong? There are some real dicks on this thread.

Hope you feel better soon, op.

@Jazsimone

Amoxicillin - No indication for five times a day - bnf.nice.org.uk/drugs/amoxicillin/

Metronidazole - No indication for five times a day -
bnf.nice.org.uk/drugs/metronidazole/

And nice try, but aciclovir is not an anti-biotic, it’s an anti-viral used to treat herpes infections and may be prescribed five times a day.

When you make such sweeping statements you need to provide actual evidence.

Doctors most definitely DO make mistakes! My child was prescribed the adult dose of antibiotics yesterday (not for tonsilitis) thank goodness the pharmacy queried it because that could have made her extremely unwell if I'd followed the initial dosage. But for the most part, there are subtle differences that make bacterial infections vs viral infections more likely.