It is up to the gp not the pharmacist ??

[Edenviolet]

Dd1 has been unwell for a while.temperature, very sore throat and cough.

Gp took a swab and gave us a prescription for antibiotics and said to get it but not made up and if dd suddenly got worse to start the course immediately otherwise to try and hold off till swab results are back but as they can take a few days just to see what happens.

Went to the pharmacy and asked for the medicine in powder form and was questioned as to why by the pharmacist. She wanted to make the antibiotics up today but as they only last for 7 days once made up and I don't know what day dd may need to start them I said no could I have it unmade. She got quite annoyed with me and started saying about antibiotic resistance etc etc.

I explained again what the gp had said but she was having none of it and wanted to make it up or refuse to do anything.
I also explained to her how poorly dd has been and that I would like the medicine all ready at home in case we need to start it rather than trying to rush and find a pharmacy, especially as my other three dcs and dh have been unwell too and dh has been struggling to even drive so its better if its there's at home to use if need be.

If dd improves and/or the swab is negative obviously I'd return it to be disposed of by the pharmacy.

She was really really off with me. She could have phoned the gp to check but didn't and kept saying it would be made up or not at all.

I then tried to buy two bottles of nurofen and two calpol and two antihistamines and got questioned even more ! I was so angry.

AIBU to think that she should have just done what the gp advised/I'd requested? I had to walk fifteen mins to the next pharmacy to get it and was nearly late for school pick up. Other pharmacy did it no problem at all.

I've often been given prescriptions just incase the DC get worse. I've never taken them to the pharmacy to have them made up unless they do, though. It is a shocking waste of money, it all comes out of the NHS budget which isn't a bottomless pit.

The pharmacist was not being unreasonable in the slightest.

It seems to me that the GP was attempting to make sure that the antibiotic was available if it proved necessary (rather than just doling out a course straight away as they would in the old days). And surely if it turns out that there is a bacterial infection it's best that the course can be started ASAP rather than a delay - more likely to eradicate it by the end of the course?

Think I will just use a different pharmacy in future as its the second time this week I've had an issue with them.the first being when they wouldn't lend us some medical supplies that dd2 has all the time and due to her being ill we had nearly run out and prescription hadn't been issued yet. They went on at us about how expensive the item is and did we realise that ??!! What are we meant to do ?use less and make dd ill? In the end we had to pay the £20.75 for one tiny item and then get a refund when had the prescription and they reminded us again about how expensive it is !

Def will be finding a better pharmacy

Make friends with your pharmacist because they're worth their wait in platinum and can save you countless wasted trips to the doctors.

If you don't like that one, change to another one and build a relationship with them so they can advise you well once they get to know you and your family.

Hope your daughter is better soon.

As has been said, the pharmacist is personally liable for the medicines prescribed. They can give out dry antibiotics but it's totally understandable that they wouldn't want to if possible - and that one would be more/less willing than another. I've been given them once as a pp was when going on holiday with a possible but not certain problem iyswim.

Fwiw I think pharmacists are the bees knees after one questioned a script that could have seriously harmed my unborn or induced miscarriage (20+ years ago now but still fresh in my mind as the potential consequences were so huge). They are a forgotten link in the health care system and most people don't realise just what their job entails. It's a lot of responsibility.

Hope everyone is feeling better soon, you sound like you really have your hands full!

I do see now I was being a bit unreasonable as didn't realise pharmacists were personally liable should anything go wrong with a medicine they prescribe, I thought they just gave out what the gp asked for and that it was down to the gp.
I still think her manner and way of questioning was wrong though she was very off and wouldn't even check with the gp about what they had said to me.

Obviously its a bit of a bad match so I will change pharmacies asap

I must have misread your previous post - a prescription hadn't been issued yet you got annoyed they wouldn't give you the medicine?

Sounds like a good pharmacist to me!

Dd2 has a lot of items on repeat which we always get from this pharmacy, but she had been ill and we ran out quicker than expected, put in an urgent prescription request at gp but needed to borrow some. The pharmacist wouldn't let us unless we paid as the item is so expensive.
Even when we had the prescription the next day we were reminded how expensive it was and that we should try and use less !

Our GP also gives out 'dry' antibiotics for my DD. We keep them in stock in case she takes ill out of hours and to try and keep her out of hospital - hospital admissions being a lot more expensive than a wasted bottle of antibiotics.
It is not difficult to mix them up - you just need to read the instructions on the side of the box for the correct amount of water. As long as you have a way of measuring that amount, it is easy. I use a 60ml syringe. I have done this in the middle of the night on a number of occasions. I have also been given dry antibiotics at the hospital pharmacy. DD needs a 2 week course and ABs only last 7 days once made up so doing it this way is the best option.

FWIW, I have had bad advice from High Street Pharmacists in the past, who have recommended over the counter drugs without asking DDs medical history or what other medication she takes. I have also had pharmacists query a diagnosis saying "who told you that?" when I said DD had scarlett fever and it had been diagnosed by a GP. And I too have had the "do you know how much this costs?" comment when ordering something which treats a potentially life threatening condition and if not given, results in dialling 999 and DD being admitted to A&E resus and spending at least one night in hospital - so I really don't care how much it costs as it probably costs less than the alternative.

The best Pharmacists I have come across are hospital ones as they seem to be more clued up to complicated selections of medication and complex patients.

I'd definitely change pharmacists. You get good and jobsworth people in all roles.
Potable water ie tap water is perfectly fine for reconstituting antibiotics. If you have a digital scale, you can weigh the water as 1ml is the same as 1g for water at room temperature ( or some scales let you change from g to ml) so the accuracy is fine.

Alternatively move to a rural location where there are GP practices which dispense the prescriptions as well ( although you don't have the pharmacist safety net!!)

Just occurred to me- if the pharmacist was concerned about you mixing the antibiotic correctly, she could have dispensed a bottle of distilled water containing the exact amount needed, then it's just a case of tipping one into the other. Then she would be covered.

parralex
Perhaps you should re-read that the sentence you just quoted me. That's actually telling us that delayed prescribing of anti-biotics is an alternate method to immediate prescribing. I don't see any 'explicit' reference to 'just in case' medicines. In fact there is no reference to 'just in case' prescribing of antibiotics in the full NICE guidelines as below: www.nice.org.uk/guidance/cg69/resources/cg69-respiratory-tract-infections-full-guideline3

And as a side note,

^The decision to prescribe an antimicrobial should always be clinically justified and the reason(s) should be recorded in
the patient’s medical record. It is important not to prescribe antimicrobials on a ‘just in case’ basis^
This is taken from guidelines that my trust uses, as do many many others.

The practice of prescribing just in case antibiotics is quite frankly old fashioned and one of the reasons we're in a rush of trying to produce new antibiotics.

And all this 'we have stocks of dry antibiotics in case they get ill' is inherently wrong. This is what is creating antibiotic resistance. People dosing up their children with antibiotics with no indication as to whether the illness is bacterial or viral.

To be fair, it's "unless they get ill in a very specific way which we know they are susceptible to and would be disastrous if left untreated".

in case they get ill, not unless

I'm a pharmacist and we give out dry powder all the time for parents to mix up at home if necessary, or if a 10 day course is required. We just provide appropriately sized oral syringes and clear instructions.
It isn't common but definitely not unheard of.
Appreciate all the pharmacist love on this thread though.

To those saying they've never heard of the medicine being dispensed as powder form before, that's bollocks.
We were in the pharmacy waiti g for one of dd's prescriptions and heard a conversation with the pharmacist and prescribeee about just that thing. The phaemacist asked the customer if she wanted it made up or to make up herself at home. She expressly told the customer that it only lasts 7 days made up and that if she had to delay start it would bebetter as powder.
So nur.

I've never heard of it before and it's surprised me how rife it seems to be.

I don't think it's 'rife' - it's something that happens (by and large) in specific situations where it makes sense. The poster who talked about 'stocks' sounded like she has a child with a serious ongoing problem which she understands how to manage. The OP's case, the GP has taken the swab, is giving a pragmatic alternative to 'start course now' and 'wait for results, and then delay some more to get the stuff'

I meant rife judging from this topic because many people have said they've heard of it done. Ive never heard of a single instance before this. Interesting to learn.

there will probably be a selection bias in posters, those who've come across it more likely to post.

I've been given unmade up medication before, antibiotics from a walk in centre for my son...they were quite happy for me to do it (you needed to add a certain amount of water then shake it) (though I am a doctor which might make a difference, and they knew this!!)

My DD will be 7 in the spring and every antibiotic she's ever had (that hasn't been IV) has been powdered for me to make at home. In fact, I've got 3 boxes of powered Zithromax in my cupboard currently. Having said that, I pay privately for all her prescriptions and do not see an NHS GP or have NHS prescriptions for her so maybe that's something to with it. Her drugs are also issued in the hospital pharmacy, not Boots.

Having said that, I'm glad the pharmacist questioned it. Especially as you were buying a shitload of OTC meds at the same time. And PP's are right, the pharmacist has final say on dispensing. They cannot, per say, refuse to prescribe what the doctor has requested (without a valid reason) but they absolutely do not need to accommodate a request without a valid reason...and not wanting to traipse out to the night & day chemist at 11pm isn't a valid reason.