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.

Bollocks, just to add. We are not stock piling. DD is mentally and physically disabled with several life limiting diseases, one of which requires almost constant antibiotics.

I've worked in pharmacy for 17 years and the only patients we give powdered antibiotics to are those who are taking them for chronic conditions and are on them constantly.
We would never give them to a patient for an acute script, there is too much that could go wrong if they are made incorrectly.
We are the nearest pharmacy to the local ooh drs and we have to correct a LOT of scripts from them. In fact the paracetamol doses are nearly always wrong and we very often have to change them.

Graysanalogy, as a microbiologist I am here to tell you that the main cause of antibiotic resistance on a population scale is the use of antibiotics in industrially farmed livestock, rather than someone having an unopened bottle of powder sat in their bathroom cupboard. HTH.

There really ought to be some kind of compulsory scientific literacy course in schools ffs.

I think there is some confusion on the "just in case" scenario here. Certainly in my case at least, we had a condition that would respond to antibiotics. The just in case bit was having them just in case dd didn't throw of the illness herself and needed the help. Therefore trying not to give antibiotics where, previously, they would have been given freely.

Giving them to be administered regardless just in case it's an illness that will respond but knowing it might not be is irresponsible of course.

So you're telling me that the over prescription of antibiotics isn't in anyway relevant and an important factor in bacterial resistance?

If so please pass your findings onto NICE, WHO and the like so they can stop pestering us about prescribing them :)

Also may as well tell ARHAI and DEFRA that they no longer need to work together to help stop the problem. DEFRA can do it themselves surely.

There really ought to be some kind of compulsory scientific literacy course in schools ffs

You may be confusing 'scientific literacy' with 'knowing stuff'.

I am very scientifically-literate, in medical/life sciences to boot. But I only only recent learned of the true impact of antibiotic use in the livestock industry. I assume I could pick concepts/facts from my specialist field that you wouldn't be familiar with. Thta doesn't make you scientifically-illiterate.

What a bizarre point to (try to) make.

If i had a question about medication and interactions, the last person i would ask is my GP!

Grays I'm sorry for not being clear, I think we may be talking at crossed purposes - what I mean is that delayed prescribing IS an acceptable alternative to immediate prescribing, and this seems to be the scenario that was described in the OP - here's a prescription, if it doesn't resolve in X time, or we ring you with a positive swab, get it dispensed. Lots of delayed prescriptions don't get cashed. That's a very commonly used primary care safety net, but a very different case to having a stockpile of antibiotics at home to crack open when the next random cold appears, which I fully agree is inappropriate.

There are other medications that people do have at home as back ups though (steroids for some asthmatics come to mind) but the vogue in primary care seems to have been away from this (in the same way that home nebulisers have become less commonly prescribed, part of the thinking being that more home treatments can lead to later primary or secondary care presentation, which can be dangerous).

FWIW, antibiotic resistance has never seemed so scary as the current time.

I dont think the pharmacist would legally be allowed yo do what the hp suggested. Yabu. Couldnt you have hold onto the script and if ds needed the medication get it that day.

After ds3 came out if hospital following a severe infection, we were given a script for 2 bottles of the antibiotic. One was to be made up and the other in powder firm for me to make up at home as they wanted him to have 2 bottles worth and the second one would go off. They just showed me the line on the bottle and said fill it up to there. No exact mm at all. Pharmacist was fine with it.

However, bloody pharmacist a few wks ago wouldn't sell me canesten pessary! Why? Because I'd come in with a prescription for something else unrelated and she said if I had thrush I should have shown the gp and got it on a prescription!!! Ridiculous!

dO you think he may have meant "getting the prescription made up" which is just getting the prescription from the pharmacist - the pharmacist. "Makes up" the prescription - if he had meant you to mix it then he would have printed up instructions for doing so and made sure you knew what you were doing and written instructions to the pharmacist - I think you misunderstood the doctor.

Dd not ds

2 Christmases ago we flew to London and on the way dd2 was ill, running a temp and ill. It happened en route ! Waited until the last day before Christmas break to see GP who said I think it is just a virus but her throat / ears are looking a bit rough. he prescribed antibiotics to be taken IF her temp was still up in 36 hrs and she was still unwell and not eating / even ice cream !!. It was in powder form . The pharmacy ( in the surgery) showed me what to do and also it was written on the packet. If they were unused I was to take them back- seal intact. They went back and I signed to say I had returned them. ( also had to call and update the doc after xmas how she was)It went on her notes as I had to take her back on another visit and they say 'oh we have seen her before but she diddn't take antibiotics'.

I have a question for the pharmacists on here - DD needs stupidly expensive tablets (each tablet costs £xs ) which are unlicensed and have to be ordered in. When i took her prescription in last week, the pharmacist was muttering moaning about where was he going to get 400 of these and did I know how much they cost.

Is it the case that the pharmacy needs to pay upfront for the stuff they stock and then claim the cost back from the NHS, or is the GP/trust/whatever it is now or hospital billed directly? He seemed overly concerned about what the tablets were costing as though it was something to do with me, rather than DD having a fairly rare condition which can't be managed by any of the cheaper treatments she's tried. But if he was having to find the money upfront, his attitude was a bit more understandable.

There are no rules regarding whether the powder form can be given out but the pharmacist would be responsible if anything went wrong so it's up to them rather than the GP whether they take the risk or not.

LeapingOverTheWall Yes the pharmacy has to pay upfront for the medicines they dispense and then claim it back from the NHS.

So why wouldn't she prescribe me an over the counter thrush medication? She definitely viewed me with suspicion and kept saying it costs £11 so if I needed it why didn't I ask for it on prescription? I know it's a 'P' medicine but I found her attitude bizarre. I just went 3 doors up to boots and bought it there. And if course it means I will avoid using that pharmacy in future.

thanks whatever - so to keep on the right side of the pharmacy I need to give them as much notice as possible of a new prescription presumably?

When ds is prescribed lots of unmade up abs at a time, it is the pharmacist who makes sure I know how to mix it up, as he is the expert at mixing up drugs.

Our pharmacist is fantastic, as is our GP, they work together, discussing or emailing each other about the best form of drug, whether I will be able to administer myself (eg for a drug available in injectible form in glass ampoules, but being administered orally for ds) and looking at contraindications. They are both incredible professionals, I have a lot of respect for them, and they treat me like an intelligent adult.

parallax80

Ah I understand completely what you mean. Sorry for the misinterpretation!

I once had a presciption for unmade amoxicilin.DS2 had a home visit (well we live near GP and he called in on his way home) and the GP made up a bottle out of his bag and wanted me to get a prescription to replace it.
The pharmacist ummed and ahhed a bit about it.

Leaping we have to pay for the medication then at the end of the month send the prescriptions off to the pricing bureau to get paid. Expensive prescriptions do get pad for more quickly but it can still take a whilr especially if there are queries

Sounds like your decision to change pharmacy's might be the best OP. The pharmacist in our local Boots has always been a bit dodgy IMO. Give out drugs or tell you to get on with it nothing much in-between. However in our local Tesco there are two really great pharmacists who always take the time to ask you lots of questions, and make suggestions. I always visit them before the doctor, and often don't both with the doctor based on their recommendations. Really, really helpful decent professionals.

When I read this I thought the GP meant take the prescription but only get it made up if the swab came back positive. That's what I would have thought.

Yanbu. Sounds reasonable to me to get powderz