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?

Yanbu, this public announcement drives me crazy. My little 8 month old has already been prescribed antibiotics twice, once for what turned out to be baby acne, the second time for eczema! I didn't give them to her on either occasion.

In my pregnancy doctors tried to out me on antibiotics twice unnecessarily which I decline and was scalded for.

Like op, they give me terrible thrush and are heavily overly prescribed by drs. This imo is their issue not the public's.

soup - there was a very interesting thread on that a while back, and the answer was that yes they may well contribute to the problem. It's not something I had really thought about before that point.

As I said previously, it sounds as though they are asking the public to self-ration. To date, the message has been largely one about collective harms- that "we" may be breeding superbugs by "our" use of antibiotics. That seems to have shifted towards a more individualised message: "Look, you or your child can have antibiotics for this, and it might help you/them to clear the infection more quickly, but you'll also be doing some damage because you/they, as an individual, may develop a resistant infection years down the line as a result of this present antibiotic use".

I'm slightly confused by this shift in register. It sounds as though they're saying that individuals, not populations, are at personal risk from antibiotic use - i.e. that if you've personally had antibiotics A, B and C in childhood, your personal risk of developing an infection that is resistant to all three is higher than that of someone who hasn't. I'm not sure how that information fits with the more collective messaging we've had to date.

SoupDragon all of these antimicrobials have an impact on drug resistance. For many years now, hospitals have stopped using harsh antimicrobials everywhere. With the exception of actual toilet basins and spillages of body fluids etc., the they use a standard detergent to clean. Antibacterial products are counter-productive and cleaning with soap and water is sufficient.

My daughters health has sadly been affected by doctors advising it’s only a virus and refusing antibiotics. At 11 months she caught 2 chest infections back to back and a delay in antibiotics has resulted in damage to her lungs.

Two points here:

1. GPs are not God. There are some good GPs, there are also lots of very bad ones. Some of them prescribe anti-biotics when they shouldn't. Some of them just prescribe them to shut the patient up.

1. Some patients are idiots. Some of them insist and insist on anti-biotics and make numerous repeat appointments day in, day out and become increasingly anxious if they do not get what they want. Weak GPs will prescribe them to shut them up or even take a look at the anxiety caused and think prescribing them anti biotics is a lesser harm than increasing their anxiety by refusing to give them.

YANBU

Have you any evidence that GPs are being told they play no part and not to change their behaviour? Of course not, there will be plenty of pressure on them as well. Just because one group of people could do more to help a problem doesn't mean another group is entirely blame free.

Such a campaign is probably as much to reduce the number of appointments such patients make, shorten the ones they do as the GP will not have to go over the basics and keep them from spreading their viruses to the (possibly vulnerable) people in the waiting room. It isn't like it's doing any harm to educate people on viruses and antibiotics.

I think its to educate people not to put pressure on their GPs by demanding antibiotics.

Obviously if GPs had no qualifications and it was the worst job in the world, we wouldnt need to try to make their lives bearable, but since they all have 4 As at Alevel and could go into banking or private industry and make x 6 as much money at least, we are all incentivised not to treat them like sh1t, and sadly a lot of the "public" do just that.

(I am not a doctor, but I am someone with 4 As at A-level who earns a lot more than one, so I appreciate the sacrifices they make for public health).

I rarely take my dcs to the doctors for bugs and colds. But on the odd occasion I do (usually to check a specific symptom like a chesty cough) I am always surprised when the doctor tries to give me a prescription for calpol/ibuprofen. Usually because I think they feel pressured to give a prescription for something.

I usually sit down with dc, tell them what the symptoms are and say 'it's probably viral but I am worried about his chest/throat/ears' or whatever. So make it clear I don't expect abs.

Dd is 13 and had abs last when she was about 4 for a uti. Ds is almost 4 and had abs twice. Once for an ear infection at 12 months old and once for a serious throat infection at 2 while we were abroad.

But I hear other parents kicking off constantly for abs. Instead of letting their dcs immune system fight off infections, even when they are bacterial. I have asthma and used to have abs at least once a year for chest infections. Usually steroids too. I couldn't get to a gp about 15 years ago (was working away, couldn't miss the course etc) and struggled through a chest infection without the abs. Never needed them since.

I am not saying that we should deliberately not take abs if a gp prescribes them. Buy even bacterial infections generally clear up and probably in the same time frame as if we had taken the abs.

I would rather struggle for a bit longer with a chest infection than have abs not work post surgery. Abs are not a miracle cure.

@moutonfou
I'm surprised to hear these operations aren't as common these days - is it just cost/capacity?

Don't know about grommets, but I seem to recall that as far as having tonsils removed goes it only makes a short-term difference to the amount of illness someone has.

That was certainly my experience. I didn't get tonsillitis again, but I constantly had viral infections.

You see people on here telling others to go and demand antibiotics

I've seen it so many times on Facebook too. Someone "fuming" that they've been "fobbed off" by a GP telling them they have a virus and then all the 'huns' pile in with "go down the surgery and DEMAND antibiotics NOW!!!!!" "sit in the waiting area and refuse to move until you get them!!!!" "definitely doesn't sound like a virus, those doctor's don't know what they're talking about!!!!" based on absolutely no medical knowledge whatsoever

Actually the public do contribute to overuse. Some badger GPs into submission, some treat themselves with fish antibiotics bought on the internet and a large percentage as really arrogant and stupid and do not fishing their doses resulting in recurring infections and therefore even more antibiotics.

Yanbu. My GP recently prescribed them to try and get rid of a weird tingling headache behind my eye and upper cheek I've had for weeks. I suggested it was more of a migraine or problem with my impacted wisdom teeth I'm convinced it's a tumour but she said the anti-b's would help . They obviously haven't made a jot of difference so I'm going back again.

Our GP usually let's us decide if ds's symptoms are severe enough to warrant antibiotic use ( given it is a condition where antibiotics might be prescribed) and often gives us a just in case prescription. Ds isn't able to cope well with discomfort in the way that a NT child the same age might.

I'm scuppered then - in the last few years I've had about 30 urine infections with at several points a daily antibiotic, cellulitis, an abscess, walking pneumonia, a kidney infection, pericoronitis requiring a fancy antibiotic drink.. as a child had reccurent URT infections due to infected adenoids (they were 4 times normal size and covered in pus) . Probably had every antibiotic in the book sadly.

I think the main thing we can all do is to finish the prescribed course.
I know so many people who will take about half and then stop, and that hugely encourages antibiotic resistance

I've had 'just in case' prescriptions too, GP said to keep a box of amoxicillin in the house for weekend/overnight use with a urine infection so wouldn't have to go to OOH necessarily. Also given me scripts for abs and said can take to chemist if things get worse , if not don't have to bother - hugely helpful.

My dc (ds1 especially) pretty much lived on antibiotics between the ages of 18mo and 4. Now they're older they haven't needed them in years.

You're right, it winds me up too. Intensive farming is so hazardous to animal health they have to pump them full of antibiotics all their lives because they'd die of infection otherwise. That is what is causing antibiotic resistance.

But far be it from the government to enforce decent animal welfare standards to avert catastrophe, nope, let's blame the patients who say "are you sure it's a virus, doctor?"

As I said previously, it sounds as though they are asking the public to self-ration. To date, the message has been largely one about collective harms- that "we" may be breeding superbugs by "our" use of antibiotics. That seems to have shifted towards a more individualised message: "Look, you or your child can have antibiotics for this, and it might help you/them to clear the infection more quickly, but you'll also be doing some damage because you/they, as an individual, may develop a resistant infection years down the line as a result of this present antibiotic use".

I'm slightly confused by this shift in register. It sounds as though they're saying that individuals, not populations, are at personal risk from antibiotic use - i.e. that if you've personally had antibiotics A, B and C in childhood, your personal risk of developing an infection that is resistant to all three is higher than that of someone who hasn't. I'm not sure how that information fits with the more collective messaging we've had to date.

Some years ago, maybe five, I had a long conversation with a microbiologist who told me that there is no individual affect to antibiotic misuse (apart from side effects) - that it was all at the population level.

Perhaps he was wrong, or perhaps the received wisdom has shifted.

I'd be very pleased if someone who knew better than me came along to clarify.

no individual affect

effect

10 lashes to me.

I'm scuppered then - in the last few years I've had about 30 urine infections with at several points a daily antibiotic, cellulitis, an abscess, walking pneumonia, a kidney infection, pericoronitis requiring a fancy antibiotic drink.. as a child had reccurent URT infections due to infected adenoids (they were 4 times normal size and covered in pus) . Probably had every antibiotic in the book sadly.

Poor you. I have recurrent UTIs as well. I now take a low-dose antibiotic (whisper) every time I have sex.

Haven't they just revised the guidelines about finishing the full course?

Not quite sure why anyone should throw a wobbly at the GPs demanding antibiotics. There is no need to use up all that time and nervous energy when if you are so inclined you can buy them over the counter on holiday or on line here.

I suppose vets need to have a more liberal prescribing policy for domestic pets as they can't explain their symptoms but the enormity of the use in agriculture is appalling.

My PIL buy it over the counter in Spain and use it whenever they feel they should even when not prescribed. I think they are the sort of people they are talking about.