To want our doctors to give us medicine?

[ditziness]

Have two kids, 11 month baby and 4 year old. DH and I got ill 3 weeks or so ago, sore and tight chested, sore throat and ears. Kids started getting it too a week after. DH went to doctor on own and got antibiotics for a chest infection. Me and kids go day after, but apparently no antibiotics needed, we've all got a virus. Meanwhile DH is fighting fit within a couple of days of antibiotics. A week later me and the kids still coughing and rotten, surviving on paracetamol and calpol, not sleeping well . On my knees really. So back to doctors, but still no antibiotics . Apparently still a virus. That DH bizarrely hasn't got.

AIBU to think they should just give us antibiotics?

But correct me if I'm wrong but -- giving ABs to someone with a viral infection isn't what leads to AB resistance. All that happens is that there is no benefit from the ABs. What increases resistance is people who do have bacterial infections but don't take the ABs properly, not finishing the whole course and things like that. Right?

Because if that's the case, doesn't that mean that if the OP takes all the ABs correctly, she's not contributing to AB resistance?

Not the case dreaming, several reasons, including over-prescribing, use in animal feed, not finishing the course, so prescribing antibiotics when not needed is indeed contributing to decrease in efficiency of them when really needed.

www.vdh.state.va.us/epidemiology/factsheets/antibiotic_Resistance.htm

www.who.int/mediacentre/factsheets/fs194/en/

It isn't about blind faith in medics and of course mistakes are sometimes made in diagnosis.

But this isn't a "very sick family" as someone said, despite the fact that the OP has every right to feel utterly miserable and fed up. We have lost sight I think of what "very sick" means.

The issue is, often, that looking after ill babies/children when you are ill yourself is awful - no sleep, worry, misery. You just want something to make it go away quicker. But GPs just cannot give antibiotics to every one who is knackered and chesty with coughing and miserable children. This is a significant number of patients every week in every surgery in the land! The point is in the majority of cases it is better for the individual to watch and wait and it is also better for society. Decisions are mostly made carefully on this basis, rather than just on a whim.

And yes, once again, it is miserable being ill in your situation OP, and I don't doubt that you all feel rubbish.

A small number of bacteria will be resistant to antibiotics just because of genetic mutations. I assume that one problem is if the sensitive bacteria are killed off by AB then this gives the resistant bacteria the opportunity to grow without competition with the sensitive bacteria. Each time this happens the number of resistant bacteria v sensitive bacteria increases. So the more exposure to antibiotics the quicker the balance between resistant and sensitive bacteria gets tipped towards the resistant bacteria.

I had a similar thing last year - went to doctor's twice (once after 2 weeks and again after a month) and was told that it was a virus - I could hear my chest wheezing (I have mild asthma). Two days after last visit, I could hardly breathe, went to walk-in centre (it was the weekend) and saw doctor who diagnosed a severe chest infection and told me off for not coming earlier...!! Started anti-biotics and was better within a week. Forgive me for not accepting diagnosis next time

Eggwiniasrevenge's answer sounds likely. Also asthmatic people seem to have a tendency towards a viral infection turning into a secondary bacterial infection.

Rest and recuperation, ha! What's that? I don't get to sleep any longer than 2 hours at a time and my husband leaves for work at 630 and gets back at 630!

Thanks for all the info and perspectives. Helps me stop feeling so angry and depressed

Baby now has funky eyes too, and both children have red rashes on their cheeks and round mouth. But I can not be bothered to take them back. I think I might hit someone if they just send me away saying that it's just a virus again.

At my age I have had enough illnesses to have a pretty good idea which are viral and which have progressed to a bacterial infection.

Gosh, you're terribly clever. I have been to medical school, worked as a doctor in A&E, intensive care and general practice, have a special interest in infectious diseases and I can't tell. Do tell me your secret.

The truth is that there is no way of knowing with certainty which illnesses are viral and which bacterial in a GP surgery (except for things like cold sores that only have one cause). Even if GPs did throat swabs or blood cultures every single time, you'd have to wait 3 days for the results, by which time many people would have recovered.

So a GP's decision whether to prescribe antibiotics is based on:

1. probability of it being a bacterial illness
2. likely risk vs benefit of prescribing - a patient with an underlying medical problem such as asthma is at more risk of serious harm from a chest infection so the threshold for prescribing will be lower.

A cough accompanied by a runny nose, sore throat etc is 99% likely to be viral. Some people will develop a bacterial infection on top though, which is why antibiotics may have a role if what starts out as a normal cold starts to get worse.

In terms of risk of prescribing, lots of people are harmed by antibiotics every year, in addition to the risk of antibiotic resistance. The harmful effects of antibiotics can be extremely serious, even fatal - including anaphylaxis and clostridium difficile infection (caused by the body's "friendly bacteria" being killed by the antibiotic).

So, OP, YANBU at being fed up of having a miserable cold. But your GP is also NBU at not wanting to prescribe if s/he thinks your illness is viral. She would be putting you and your children at risk of serious harm for no benefit if she prescribed antibiotics for an illness that is almost certainly viral.

If you think they are getting worse OP, do take them back. Virus or not, your GP should be happy to see you if you are still worried.

I realise the system seems confusing from a distance, but it does make sense to watch and wait in most cases. You have done that and are still worried - just say exactly that: you realise it is a virus but you are concerned that after ? weeks they are getting worse and can he/she examine them again. Good luck

There is no such thing as JUST a virus, people seem to have this idea that if something is viral that it is a mild illness it isn't its just an illness that is viral and therefore antibiotics won't touch which makes things harder.

Sue - So it took a week after getting the antibiotics for you to be better, ever thought that the virus had just ran its natural course?

Yaaaaaaaaaaawwwwwwwwwwwwwwnnnnnnnnn
You all hate GP's so much, we're al useless blah blah. Roll on NHS privatisation and then you can all pay for care you so much take for granted.

Your DH was given ABs because he is asthmatic and more likely to get a secondary bacterial infection. Which if he does would be highly dangerous for him. I know its rough but even if it is a bacterial infection (unlikely) you have a perfectly functioning immune system which will sort it out in the end. The problem is that anti-biotic resistance is a massive and REAL problem. I think we are shutting the door after the stable has bolted but we need to take responsibility for it. ABs will make no difference if you have viruses - We all have this virus, my mum was given ABs today because she is immunocompromised and likely to have a secondary infection. A cold always goes to her chest, and she always given antibiotics - DP, DD and myself have had it for roughly three weeks - i wont go to the doctors.

macdoodle Do you mean we "all" hate or that some do? I've seen loads of posts in other threads praising all areas of the NHS.

Yep, it won't be long before the NHS crumbles and everyone can pay to see their doctor instead. Bring it on. At least it might deter so many of the worried well darkening our doors!

Oh dear, cos GP's are really badly paid in the NHS. This drives me mad in all areas of the public sector - the fact that people are doing us, the customer, a favour by doing their jobs, for which (in this case at least) they are handsomely rewarded, by us the customers and taxpayers.

Sirzy Having had a persistent cough (with green phlegm - sorry if TMI) and breathlessness that had gradually been getting worse for a month, and having had a wheeze in my lungs that I recognised as my asthma getting worse, despite using my inhalers, when I took the anti-biotics and the cough/phlegm started to clear up after two days and was gone in a week - meaning that my lungs were clear and the wheeze had gone - I don't think that it's unreasonable to link the two things...

Oh I'm so sorry Gales, you work for free do you
I am paid much less than equivalent professionals in the private sector. Roll on private healthcare, you'll discover it costs much more than you apparantly "pay" your NHS GP.

Gales - i dont understand your point ARe you suggesting that "The customer is always right" and if we demand antibiotics we should be given them, even if the doctor doesn't consider it to be the best course of treatment.

Patients aren't customers yet!!

Maybe so macdoodle, but I'd also be able to demand a reasonable level of customer service and without those "worried well" far fewer GPs would be required, so I suspect you actually wouldn't be able to earn as much as you think in a supply and demand economy.

Patients absolutely are customers - who else are you working for?

No I absolutely don't think we should get antibiotics or any other meds if we don't need them - in fact I have had a long discussion with my GP about why I (and he) thought DS1 didn't need them when the HV was insisting repeatedly that he did. I just object to this "we're doing you a favour by seeing/speaking to you at all" attitude. Not from all doctors by any means, but there were a couple of posts here where that attitude was apparent and it made me see red.

I'm sorry you didnt answer my question. Do you in fact work for free? I wonder how much you would value my 11 hour day today. When I work for Richard Branson et al, I can guarantee you 100% I will be knocking off at 5pm on the dot and not doing all the fucking, bollocksy, nonsensical, demanding, entitled shite other stuff that I am not actually paid to do at all.

I don't work for free, but I wonder what your 11 hours day makes your hourly rate?

I often worked an 11 hour day in the private sector working for ungrateful customers - to whom I had to be unfailingly polite and helpful. I know very few professionals who routinely work 9-5, no-one on a decent salary.

If it's so awful and so easy to get a cushy number elsewhere that would pay more, why are you still doing it?

I actually like my job despite people like you the way I am treated with increasing frequency.
My hourly rate over a month is not fantastic, what would you expect it to be? I am curious. My contracted hours are certainly not 11 hours a day.
I would like to point out that in order to be able to practice, I have to shell out almost £800 a month, so my disposable income is far less than someone on a lower income.

Just worked it out for you. My GROSS hourly rate today was £27/hour. Thats before tax, and other expenses. Brilliant huh?