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?

There's emerging evidence that repeated antibiotic use in children has an association with obesity later on. Gut micromes are probably stable by 2-3 years but having gut flora altered prior to that may be problematic.

www.sciencedaily.com/releases/2016/03/160322120041.htm

Which is not to say that antibiotics should be withhold in favour of serious bacterial illness.

That's a bog-standard family of healthy, happy DCs who must get through 12 lots of antibiotics each year

Errrrr that's not average or 'normal' for healthy children. I reckon my tween and teen haven't had more than 12 lots of antibiotics between them in their lives and most of those were in their 'under 5' years!!!! (and DH and I probably average one lot every ten years).

I think we had 20 years or so between the 1960s and 80s where anti-biotics were seen as the wonder drugs they were, and Drs then tended to overprescribe. Now we know more about AB resistence, but on the whole the public are only just catching up with this.

I don't know if it's been mentioned already but there's a major issue with one person getting anti biotics, not finishing the course and them giving the remaining pills to a friend. It's incredibly stupid but it happens all the time

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

Possibly because prescriptions for children are free?

Some people lie about how long they've been ill for, so that they get given antibiotics sooner than they should.

I've never "asked" my GP for antibiotics. Though I've been prescribed them many times. In my experience, it's the GP who has been the decision maker, no pressure at all from me.

Last time, I didn't even bother taking them. I thought I'd just wait a couple of days to see if my symptoms improved without, and they did!

I hope that the message is getting through, not just to patients, but also to the GP's. It's a two way street!

It isn't just the overprescribing, but years ago, I can't remember anyone finishing the dose given. Nearly everyone would take them until they felt better and hang onto some, for when they felt chesty again.

I'm Vegan for lots of reasons, one being that we can't carry on eating the amount of farmed aminal products that we do, without serious consequences, to ourselves and the planet, in general.

I agree that this up to the Doctors to decide and not be dictated to by their patients, it's not like finding a GP is easy, so they won't lose Patients without being able to replace them.

There have been two occasions when it was assumed that I had Pneumonia when I didn't, but if they have to cost cut, it would have meant a Xray, first, so perhaps some antibiotics are being handed out, to save money.

This all links together, though. People can't take the time off work when they first get ill, so infections develop and worsen. Whereas if they rested, they wouldn't need antibiotics.

Take time off and you can be sacked, or not paid for sick leave. Doctors appreciate this, so prescribe, because "go home and rest for two/three days" can't be done.

I hope the hand washing campaign starts up again because infection control measures really make a difference. I have an autoimmune condition, so a cough/cold often turns into an infection.

Posters were proudly declaring that they won't be getting a Flu vaccine this year, they are being part of the problem.

Some people lie about how long they've been ill for, so that they get given antibiotics sooner than they should.

This also. People will do almost anything to get antibiotics in some cases. I don't honestly think the GPs are to blame here, they have to act on what their told in primary care. They don't have bloods or xrays or days worth of observations to go on, they take a history from the patient. If the patient has already been to see Dr. Google they will tell the GP whatever they want.

Yanbu. The buck stops with the gp ultimately. That said, there are lots of people who expect them when not needed. No doubt the same people that clog up appts because they've had a cold/sore throat/cough for all of two days. Those things generally don't require antibiotics (obviously I appreciate there may be exceptions or if its ongoing).

I think pharmacists should be pushed more so joe public seeks their advice more often. Too many appts are unnecessarily taken up by things gps can do nothing about or a pharmacist could have helped with.

Unless I'm very certain i need to see an actual gp i ask a pharmacist or ask the drs receptionist to check if I need to actually see anyone. My gp has been happy to prescribe some things via a quick ask through reception rather than taking up an appt.

This may be of interest: www.theguardian.com/commentisfree/2017/oct/26/antibiotics-resistance-crisis-patients-antimicrobial-resistance#comments

On one hand, I agree that it is frustrating how it seems that society/worldwide problems are often portrayed as individual household issues when far larger causes (and room for improvements) are mainly industrial. It seems to pushing blame and burden on those with the least resources to do anything about it.

On the other, a campaign that helps people understand how antibiotic and their bodies work and an open discussion of multiple ways to treat things could be very beneficial both for patients and medical staff. As someone with chronic sinusitis, there is some debate on best treatment, but I just go with whatever they suggest when I've gotten to the point of ending up at the GP or nurse in agony.

I think also with some of the advertising around cleaners and soaps, there is some confusion that it would be nice to have clearer information on in relation to antibiotic overuse and concerns around antibiotic resistant strains and the concerns around the immune systems

Museum

My understanding is the same as yours - that it will be on a population level because the evolution of resistant bacteria isn't taking place within a single persons body generally (or not of harmful bacteria).

However, assuming we are looking at harm on an individual level, I suppose one plausible explanation of this could be plasmid transfer. Antibiotic resistance genes are generally held on small DNA circles called plasmids. We think of bacteria as reproducing asexually, but actually they can transfer these plasmids amongst themselves, if they are of a compatible type. So I suppose it's plausible that if you have taken many sets of antibiotics more of your non-harmful bacteria will have resistance plasmids than they would otherwise and they may then be more likely to transfer these plasmids into harmful bacteria you come into contact with, and thus you may be more likely to get an antibiotic resistant bacterial infection.

That is VERY MUCH just a thought experiment though, I haven't checked the actual research at all, just applied my knowledge to the situation so there could be flaws in it (e.g. around ease of transfer, frequency etc).

I self medicate.

"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."

There has been a recent study that challenges that:

www.theguardian.com/society/2017/jul/26/rule-patients-must-finish-antibiotics-course-wrong-study-says

The big problem seems to be routinely feeding antibiotics to healthy animals in countries such as China and the US. There's a good piece about it on the NHS site:

www.nhs.uk/news/medication/antibiotic-use-in-farm-animals-threatens-human-health/

I think a lot of people go to the GPS with cold symptoms too soon. Bed rest, paracetamol and fluids normally cure most things. And time.
For my child My Gp used to give me a script for antibiotics only to be used if her symptoms had not improved after about 5-7 days.

She never needed nor took them.

Friends in France stuck their kids on them all the bloody time.
Just different attitude I suppose.

The poster with the child who has febrile seizures... You don't need antibiotics to treat a febrile seizure. This kind of thinking really epitomises the problem facing GPS... Patients come in and say 'oh I know you don't give antibiotics for viruses but little jinny has to have them because he gets high temperatures...' not necessarily the patients fault, they had them once little Johnny got better so they them make a link between the antibiotics and getting better, when in fact if it's a virus Johnny would have git better in the same time frame.

Temperatures are part of being unwell and not a sign it's a bacterial infection.

GPS are now being pressured to identify sepsis and where antibiotics are needed urgently..but early bacterial infections look like early viral infections. . So damned if we do, damned if we don't.

I'm glad I wasn't being dumb about antibacterial cleaning products. I always thought they probably weren't a good thing. If they are a contributing factor, it makes you wonder why they are so readily available.

Hi OP. I saw you wrote that antibiotics caused you to have problems with your vaginal health. I am assuming you mean candida. Candida lives on sugar, so if you go on a diet that is free of carbohydrates and sugar for a month it will starve the candida to death. Remember that there is also sugar in fruit so you'll have to avoid that for a month as well. Yes, I know. Very boring, but it works.

I have only had antibiotics about 5 times in my entire life (I am 57), my 17 year old has never had them, my 2 boys only rarely.
We're just lucky I guess, but then I very rarely go the GPs anyway. I was a nurse before I had my kids and this was being discussed then, 30 years ago.
I wouldn't dream of taking either myself or my kids to the doctor with a standard cough and cold, or a 24 hour d and v bug. Save the NHS resources for people who are genuinely ill, and can't recover from basic nursing care or OTC medicine.
The use of antibiotics in meat production is an interesting point though.I've been vegetarian for 20 years, and my children only eat very small amounts of meat. I wonder if this has improved our resistance to infections.

Surely educating anyone about antibiotic overuse is ‘a good thing’. Yes GPs are gatekeepers in this country, but if it led to fewer people requesting or more people questioning necessity, prescription rates would go down.

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!

No - there is a growing school of thought that nuking every bacteria in sight is adding to the problem. Perhaps not as acutely as the misuse of antibiotics, but still causing problems down the line with bacteria mutating.

But try telling that to the women on MN who squeal about "bugs" and "germs", use 2 bottles of bleach a day, stick Dettol in their washing machine and won't leave the house without three packs of antibac wipes.

Soap and water should be the default setting.