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?

I'm 33 and have probably had 50+ courses of antibiotics
I've always finished the course, but if I was diagnosed earlier I wouldn't have needed all those antibiotics. Since diagnosis of my condition I've had none

Because some people are utterly convined that they're a cure all & will keep taking up appointments until they get what they want.

I can probably count on 1 hand the number of times I've been prescribed them but that's because some of those times I've ended up in hospital as I'm severely allergic to penicillin, the 1 that erythromycin comes from (the actual name escapes me) & Fluoroquinolones. Of course this means when I do need them it's a bloody nightmare as the poor gp has a very limited choice.

OTOH I'm getting a bit fed up of the assumption that all I want is AB whenever I go to the GP.
A glance at my notes will reveal I rarely attend, I average less than one visit a year.
The last time I went I had a terrifying night with a nasty chest. I was struggling for breath, but improved in the morning, I went to the doctors as I wanted to check there was nothing underlying etc. As i had never suffered so badly before. I got scowled at, told I'm not getting antibiotics, and asked what I wanted them to do.
I just wanted reassurance, my chest listened to, an explanation as to why I may have had such difficulties the night before. Instead I got treated like dirt, like an antibiotics junkie after a hit.

Surely a GP has the final say? They wouldn’t bow to pressure if I pestered them for some kind of strong painkiller if I didn’t need it? Agree 100% with the OP

Ward manager - "We need to reduce the amount of times the police attend ED"

Patient assaults doctor for not prescribing.

Doctor prescribes.

Organic meat/dairy animals can have had antibiotic treatment in it's lifetime, the difference is that bacterial infection must be confirmed in the animal, not just assumed or antibiotics used prophylactically/preventatively....

Only certain antibiotics are used in food producing animals and there is a withdrawal period where animal products can't go in to the food chain until a period of time has elapsed where the antibiotic has been eliminated from the tissues (the drug must have had clinical trials to prove this) all milk is tested for traces of antibiotics and is dumped if traces are found (plus farmer is fined).

That's in the UK/EU...

In USA they can give blanket antibiotics to improve growth rates in farm animals.... In China they use last-line human antibiotics routinely in pigs!?

There is also misunderstanding about antibiotics in meat.... Even eating a Chinese pork chop treated with hardcore antibiotics will not cause antibiotic resistance in you... But that animal could be acting as a living petri dish, allowing naturally occurring bacteria to develop and swap resistance with other bugs.... Eventually producing multi resistant strains of existing bugs like staphs or ecoli which may contaminate food via faeces at processing, transfer to humans handling animals or contaminate the environment/water etc.

Unfortunately this can be a similar scenario in a human/veterinary patient treated with multiple courses of antibiotics or hospital acquired infection where less than stringent hygiene allows multiple bugs+antibiotics to coexist, creating all sorts of multiresistant combinations.

We took baby ds to the doctor yesterday. I thought he maybe had a cold but as he’s only 4 weeks and my pfb I wanted advice from dr.

I recently switched to this practice so it was only the second time I’d been in. There were signs up advising patients that if they were thought to have a virus they wouldn’t get any antibiotics.

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

That’s a massive amount and not normal unless your children have some sort of medical condition. Most ear infections and tonsillitis clears up by itself. And it’s not having a high temperature that causes a febrile convulsion, it’s the temperature rising rapidly that is thought to cause it and it will happen regardless of anti pyretics.

I hate antibiotics, they make me feel worse than the original illness, so I never taken them, even when I probably should. I haven't had any in years and neither has DH or DD2

There's lots of signs up all over our surgery stating that people with viruses won't be given antibiotics. I had to drop a repeat prescription off for DH the other day and there was a man absolutely ranting and raving at the receptionist because he hadn't been prescribed antibiotics.

My DD1 has had lots of ear and throat problems. She was on a low dose antibiotics for contestant ear infections for for nearly 2 years before they agreed for her to have grommets. The last few years she's getting recurrent tonsillitis - but they won't agree to remove her tonsils, so she's had about 6 courses of antibiotics this year alone. Then I get told off for having too many courses of antibiotics. Can't win!

Nobody looks at issues like this in a holistic way. People go to the docs with virus symptoms because they can’t do “bed rest and fluids”. No-one can take a couple of days off work every time they get a bad cold, tonsillitis, sinusitis or whatever, even though that may well be the right treatment, and tbh, two or three weeks with tonsillitis isn’t anyone’s idea of fun.

The net result is that people want and need a cure - the real cure (a couple or few days off work) isn’t available so they go for the cure that is. That’s not a cure either because ABs don’t work for viruses. What’s the answer? I don’t want to sit next to someone who has staggered into work spluttering virus everywhere thanks very much.

To an extent they should be, as some illness would be avoided by people taking better care of their own health. Better diet, walking more instead of going by car for short journeys, less or no drinking, for example.

The over-use and the possibility that they may become ineffective is something not to be taken lightly.

We need the testing so the docs know if it's bacterial and which bacteria. This exists it's needed!
Stop using them on farm animals.
Make them prescription only globally.
The problem isn't in the U.K. Really as we have prescription only and do little farming/use much less blanket anti biotic on farm animals compared to other countries.
But the testing would help hugely!

If the use was reduced worldwide in agriculture and only used when necessary that would be a good start. However due to factory farming it's easier just to give them routinely.
I used to work with someone who would take them as soon as she started with a cold as her mum would buy a load in Turkey to bring back. We couldn't ever get through to her that she didn't need them for a cold.

Yes the issue of missing time off school (and being hounded for it) with a 'bug' (whether bacterial or viral) must play some part in making parents take their DC to the GP and demand antibiotics, when a couple of days of TLC at home would do the trick as effectively. But schools attendance targets don't really allow for that these days, do they?

We have very robust constitutions in our house possibly because we were brought up in an era when you didn't just go to the GP with every sniffle - you had to be really ill! And TBQH that's the rule we still apply with our DC. I'm sure they're less likely to be floored by a viral/bacterial infection because their immune systems have become stronger for fighting off previous illness without a visit to the doctor and a 'script' for medication.

I continue to be at how many people seem to go to the doctors for every little thing. It seems to be a default for many whereas in the past it was the last resort.

And it annoys me that despite being very very reluctant and super infrequent antibiotic users in our household, one day when we are seriously ill and need them we may have a bug that's resistant to them because of other people's over-use/some GPs irresponsibility in prescribing them.

Perhaps ABs need to become a 'controlled' medication that requires an extra level of permission to be prescribed?

And I'm not anti-medics (come from a nuclear and extended family who have given professional lives' service to the NHS since its founding days).

There's also the microdose/occupational exposure problem, which is growing.

The e-coli I harbour/ed in my gut is multidrug resistant. I got a UTI last year that turned into sepsis and they had to try something like 8 different IV antibiotics before they turned the ship. It's probably because I have been giving antibiotics with my bare hands for 16 years as a family carer, the microbiologist said (or shouted from the doorway, hahaha).

There's also the microdose/occupational exposure problem, which is growing very true.

Some members of the public demand antibiotic when they’re not required
I was sat next to a parent at a party,complaining vociferously that her child wasn’t prescribed antibiotics for cold. (Antibiotics do not treat the cold as cold is a virus) however the majority of the other guests were agreeing with her... advising she see another GP or demand antibiotics. So unfortunately there is a pressure from some

Vets and doctors are getting the campaign messages too. Veterinary antibiotic use has declined massively in the last few years. But if the public are aware too it's much easier to say to someone 'i am not sure if your dog needs antibiotics, we are trying to reduce our usage so try these supportive treatment s first and come back in 2 days for a recheck ' whereas if the public have no idea they start complaining that the stupid vet is trying to rip them off/is incompetent.

AB use in farming in very restricted in the EU but should be restricted further IMO. The real worry is countries where they can be obtained over the counter and are used widely in farm animals (USA being one example of the latter)

When I worked in elderly care, we routinely had clients who were on almost constant courses of antibiotics for chest infections. They were at end of life, but relatives often insisted upon prolonging their existence by treating end of life infections.

My dentist prescribed me antibiotics when I came back with toothache a day after a filling. Didn't even examine me! I didn't fill the script.

When dd was prescribed antibiotics after an injury, she wasn't even presenting with an infection; it was purely preventative, gave her a raging bout of thrush and for what?! She was even more miserable than necessary. She cut back on sugar intake and took probiotics daily for a couple of weeks to help rebalance her gut flora.

It is interesting to note that antibiotics fatten up farm animals. Could this be a contributing factor to the human obesity issue?

I can’t imagine that many GPs would have the ability to refuse to prescribe antibiotics for a very frail, old person because it is their time to go. What would they say to the relatives? There’d be an outcry. Very elderly people do have to die of something, but infection is unacceptable apparently. The public don’t appear to have an emotionally mature response or understanding of end of life issues so can’t deal with it.

As a mum who has experienced their child going through sepsis from a antibiotic resistant bacteria ( VRE ) it angers me that I see some of my friends pushing for antibiotics when their kids have a viral.

My daughter has had well over 20 courses of Iv antibiotics ( she has health problems including a central line and intestinal failure )
Everytime she spikes a fever she has to be started on Ivabs until blood cultures come back.

One morning ( we were already in hospital ) I woke up to 3 nurses and 3 doctors my daughter had a fever and was grunting really badly.
She was moved to HDU where they had pumped her with antibiotics and Iv bolouses and nothing was working.
By 9 pm that night she was in septic shock and in a cats ambulance to ICU on life support at age just 20 months.

She had care vancamysion resistant encroccili - which she is not colonised in the gut with for life.

As well as this over time her body has started reacting to other antibiotics and now we are slowly running out of ones she can have all by the age of 4.

It is important we try and spread awareness of this to the public as much as possible.