To wonder why the public are blamed for antibiotic overuse?

[moutonfou]

I heard some kind of public announcement on the radio today berating us for over-using antibiotics and urging us to stop.

AIBU to think that as antibiotics are prescription-only, it's medical professionals (and farmers) who are responsible for any overuse? Yes, I'm sure some patients with no idea how they work want them for anything and everything, but all a GP has to say is 'I'm afraid antibiotics only kill bacteria and you have a virus.'

Personally I detest antibiotics as they give me thrush and diarrhoea every time, but if the GP deems that I need them, I take them. Does the government think I should be protesting or refusing or something?

*That's a bog-standard family of healthy, happy DCs who must get through 12 lots of antibiotics each year
That's a huge amount and I don't think that's the norm at all. I have three kids of varying ages, none of whom have underlying medical conditions. The youngest is 9, last time he had antibiotics was when he trapped his fingers in the door at 18 months old and the wound got infected. I honestly cannot remember the last time the other two had them, the oldest is 14 and I vaguely remember going to school to dish out the yellow liquid at lunchtime when he was about 7. I had a fairly major op last year and was given prophylactic antibiotics in theatre, then had annother course a couple of weeks later when they were worried about potential infection around my scar.

Antibiotics for things like tonsilitis and eat infections are fairly pointless in my opinion as they get better on their own in most cases. I would say a GP who is dispensing antibiotics to a family on average once a month needs to be pulled up on that. And the family should stop asking!!

But antibiotics in meat? Avoiding gruesome videos or radical vegans - where can I find more info about this?

I believe meat labeled organic can't have been treated with antibiotics.

In the US farmers use antibiotics in cattle all the time to prevent disease rather than just to treat disease. That is illegal in the EU but it is still used far more than in humans. Most animal rights videos and articles on the internet concentrate on the US system though and don't mention that it is different here.

There was a discussion about this on Radio 4 yesterday (Inside Health I think?). Apparently there’s evidence that some people are ‘shopping around’ for antibiotics by attending out-of-hours GPs etc if their regular GP won’t provide them. They also said that research suggests antibiotics are prescribed more frequently in the afternoon/later appointment slots as by then GPs have been ground down by patients’ constant demands for them! There’s a lot of public ignorance out there - just the other day my DM was complaining that she couldn’t get antibiotics for the ‘bug’
she had, that drugs in the UK were too tightly controlled and that they should be available over the counter at pharmarcies.

The prospect of antibiotic resistance is terrifying. I agree that GPs are the professionals and do need to stand firm, but this must be very challenging at times!

Studies also show that GPs are more likely to dish out unnecessary antbiotics in the afternoon, when they're tired.
www.ncbi.nlm.nih.gov/pmc/articles/PMC4648561/

Longer lunch breaks for GPs to recharge their batteries? (Cue dozens of posts from harrassed GPs saying "lunch break? what's that??")

I'd love to see a drive towards more transparent and specific meat standards, starting with the abolition of the preposterous term 'organic'.

-pesticide free
-antibiotic free
-sustainably reared e.g. did not contribute to deforestation (I'm sure someone will come along and point out that meat is inherently unsustainable, and they will be correct).

Interesting that ear infections and tonsillitis are coming up frequently as I had both chronically as a kid and pretty early on (age 4) had tonsils whipped out and grommets put in. It resolved both - many courses of antibiotics, time off school, etc avoided. I'm surprised to hear these operations aren't as common these days - is it just cost/capacity?

I agree OP, I have taken anti-biotics twice in my life both just post-partum but I have been offered them at 90% of my visits. When I first saw the campaign my thought was this needs to be a two pronged approach aimed at both medics and patients. There are both unreasonable patients and anti-biotic-happy doctors, neither should be downplayed.

Patients often don’t finish their antibiotic course, which can lead to antibiotic resistance. As soon as they start to feel better they stop taking them.

Also see a huge number of ‘false allergies’ to antibiotics, which means that a less appropriate one needs to be given in some cases. Stomach upsets and nausea are not allergies. I’m not sure if people realise that when they tell an HCP that they are allergic to an antibiotic it goes on record and they will never receive that drug again, obviously. Who would take that chance, prescribing a drug that someone states they are allergic to?

I only buy organic animal products now due to antibiotics in intensively reared meat.
They are given in huge amounts both to prevent infections in cramped conditions and because they make animals gain weight faster.
A miracle of modern medicine squandered. God help us when we're back in a pre-antibiotic world.

Yes QueenJane I don't think people sometimes realise what antibiotics do, ie they kill bacteria good and bad. They have a massive short term impact on gut health (and in my case vaginal health). They really need balancing against the risks of whatever undesired bacteria are present.

I think the issue is people wasting GP time by booking an appointment for things like ear ache/sore throat cough etc when with education (what this campaign is about) they will realise these things are caused by viruses and don't need to be seen by GP's.

It is annoying when you hear people moaning that by the time they got an appointment the condition had got better by itself - that's because you didn't need to be seen in the first place hence the non urgent appointment.

Also the people who complain that they have to give a brief description of what the problem is so they can be triaged. A phone call is often all that is needed.

Of course Tory underfunding of the NHS is ultimately to blame for NHS pressure but patient education will help relieve some pressure.

Yes Max and that's why organic chicken breasts cost £6-7 versus £3 for the standard. People seem to think it's just a premium you pay for 'posh meat'. No, that's what it costs to rear animals sustainably. In the past people viewed affording meat as a luxury, now it's an expectation.

I have actually been told by a GP "You have a virus, here's a prescription for antibiotics."

My dm is a gp and worked for many years in a deprived area of London. She would have huge amounts of people register as a visitor, bring a translator with them as they spoke no English (only stating this as it was very easy for DM's explanations to be lost in translation) and demand antibiotics and refuse to leave until she prescribed them. This was without them having any illness, they just wanted to have them just in case. The surgery was plastered in posters saying do not demand antibiotics, gp knows best treatment etc. She had to regularly get police involved after being threatened when she refused.

In some cases it really is the public who think antibiotics are some kind of cure all.

Absolutely OP. GPs need to pull their big girl/boy pants on and say no. 'Clients' across all kinds of sectors demand all kinds of things. Doesn't mean you give into them.

We all take antibiotics every day, whether we want it or not.

They are in the chicken we eat, in the eggs and the meat. It's a huge problem which is not being addressed properly.

There are many countries where you can buy antibiotics over the counter and just take them as and when you please. That's not helping.

Also, there has been some advice recently which contradicts what we have been told until now, to take the whole course even if you feel better. Now the thinking is that this is what builds up resistance.

There are many factors in this, not just the public.

Can I ask a dumb question about antibacterial hand wash/laundry cleanser/surface cleaner type things.... do they have an impact on this too or are they completely different? I've always wondered!

Antibiotics in animals, need to be prescribed. There is a lot of misinformation out there.

No, they contribute to the problem as well.

Afaik, it's mostly the misuse rather than the overuse.
It's people not taking the full course or not taking them at regular intervals.
Of course the more people take antibiotics for things that don't need them, the more people misuse them.

I've always assumed it's due to overworked doctors in primary care.

For eg - most tonsillitis in preschoolers is viral. You get pus on the tonsils with both viral and bacterial tonsillitis. It needs to be treated if it's strep but it's much faster to write a script than find a swab, take a decent tonsillitis swab from a reluctant child, label it, fill in a request form, send it to the lab and follow up the results. Not to mention explaining to the anxious parent that most of the time antibiotics aren't necessary and that pus/fever/pain etc do not mean bacteria even though that's what the previous doctor said.

i suppose the are prescribed, but does that mean they are used the way they ought?
I would disagree, and that's from experience.

I'm not unsympathetic to GPs at all but I do think in general many of them need to be far firmer about not prescribing unsuitable medication.

I think it’s because often the population as a whole pop off the the doctors at the first sign of an snuffle ... I have 4 children, 3 of which have never really had the, (the twins had them after they were born as one had strep b, and the other child had them after surgery to reattach a finger top). But none of usual issues. My eldest has had them as he gets eczema quite badly and it can get infected, so had antibiotic creams. That’s it.

As a whole our family never have them, I have post surgical, that’s it. We are not a super healthy family, I didn’t do extended breastfeeding, two of my children had no more than a weeks worth, I just think it’s because we don’t pop back and forth the doctors. But perhaps we are just an oddity, in comparison, all my friends kids have them several times a year each.