To make a complaint to my doctor

[Mrskg1983]

I am 5 almost 6 weeks pregnant and had been suffering with a sinus infection up until Wednesday just gone. I had it for about 4 weeks and it was pretty bad. So the previous Wednesday I had had enough as it wasn't getting better so I went to the doc, told her I was 4 weeks pregnant and she gave me a prescription for Erythromycin. Her system said that was the drug to give when pregnant. I'm not allergic to penicillin. Anyway, I took the 5 day course and finished on Monday just gone. Then the next day it is in the paper and there has been a study done by the BMJ comparing the use of erythromycin to penicillin in early pregnancy and how there is an increased risk in cardiac defects and erythromycin should be used with caution. This was very upsetting to read, and more upsetting because I could have had penicillin. I know the risk is still low but I feel cross because its added more anxiety to an already nerve-wracking time. On further research there are quite a few studies done before this recent study that have found a link between erythromycin and cardiac defects so it is not necessarily new evidence either. Would like to hear how other people feel about this?

Your gp will have followed NICE guidelines on medication. By all means go see your gp again for clarification, but not to complain.

You've already posted about this?

Erythromycin us a really common drug to prescribe in pregnancy. Agree with going in to discuss your fears with your doctor, but complaining is silly. Your G.P. will have followed guidelines.

Norwegian study finding no risk.
www.ncbi.nlm.nih.gov/pmc/articles/PMC3522819/

So just accept that there is now a higher risk of there being a problem?

NHS guidelines
www.nhs.uk/medicines/erythromycin/

Feather mucker... I hadn't posted about the new development with the new study.

It’s always upsetting to have something like this happen, but after reading around it doesn’t look like your GP was wrong.

I’ve linked below to the advice from the British Teratology information service which summarises the evidence base for drug safety in pregnancy. The evidence overall suggests it is safe. If you look at a few other drugs on this site you’ll see that they almost all have a few possible issues that theoretically might be linked to taking the medication - erythromycin isn’t unusual in this.

I think your GP made a mistake in not explaining this very clearly to you, and really they might have printed this page out for you to read, which might have helped.

www.medicinesinpregnancy.org/Medicine--pregnancy/Erythromycin/

They can only go by NICE

One study isnt conclusive and other studies, contradict it.

Dr wakefields one study was a load of bollocks.

Speak to them uf you are worried, but I dint thi k you should assume they have done something wrong, because you read an article in one study.

Thank you for the links

Well you are in very very early pregnancy so it is a worrying time. Your nerves and anxiety are heightened! I think you need to be rational In the fact that the risk is very very low. Both my kids are adopted and were exposed to far worse and they’re fine. It’s hard I know , but I’m sure it’ll all be ok x

NICE guidance says either is fine in pregnancy. Realistically your GP can’t read every study on every condition, that’s the reason guidelines exist and they followed them.

OK thanks guys. I will chat to my doc more but yes won't make a complaint. 😊

It's very difficult to prove a drug safe in pregnancy because testing them in pregnant people is fraught with ethical concerns. They've been saying paracetamol is safe for years and it's now coming out that it may cause infertility in the fetus, but the advice has not yet changed because there needs to be a sizable body of good-quality research done first. And I believe pretty much all antibiotics have been linked to dental problems if taken in early pregnancy. Ultimately, if you need them you've got to have them, but no one can or should tell you they're totally safe.

YABU

I’ve had a look at the new study (incidentally this was published just a few days ago and is a new study, so it’s really not your GP’s fault if they didn’t know about it!)

Have you read this bit?

Macrolide prescribing during the first trimester was associated with an increased risk of any major malformation compared with penicillin (27.65 v 17.65 per 1000, adjusted risk ratio 1.55)

This means that in the penicillin group, 17 out of a thousand babies were born with a birth defect. In the erythromycin group 27 out of a thousand were.

The confidence interval for this statistic is 1.09-2 - this means that it’s possible the risk is even lower and the stat above is overstating it.

We’re talking about tiny numbers here, compared to huge numbers of healthy babies born, so this really isn’t something to be panicking over.

You’re over reacting. To be honest, there isn’t really anything to discuss with them....she doesn’t owe you an apology or whatever else you are expecting. erythromycin is commonly prescribed during pregnancy and she did so within guidelines. Your baby will be fine. You don’t need anything further doing. Let it go.

Becausereasons / sleepy mummy 2019 thank you for talking sense to me and looking further into the study.

Absolutely seek reassurance from your doctor, and let them know that you have heightened health anxieties since pregnancy. I don’t think a complaint would go anywhere.

Mainly because your doctor did nothing wrong with the prescription, they were following medical guidance at the time. Also the random article you read has actually not altered medical guidance either. So either it’s scaremongering or the study isn’t substantial enough. Therefore your GP wasn’t negligent.

Thank you, yes I will do that

To be honest, as an RN, not a midwife, your doctor followed the UK protocol for prescribing antibiotics in pregnancy. Doesn’t really sound like grounds for a complaint . I don’t blame you for being anxious- pregnancy, especially early pregnancy is an anxious time, understandably, and you just want to do everything right. Maybe another visit to the GP for further explanation and reassurance? Congrats on the baby!💐

the problem with any of these studies is this: your dc has no problem you don't report that you had an infection & needed antibiotic -your dc had a problem you think back to everything that happened in your pregnancy
Other thing I always think is this: if dc does have (heart issues autism etc etc etc) how can you be sure that it wasn't (a) hereditary, (b) because of the infection (c) something that just happened -ie natural mutation or whatever - in pregnancy or in childbirth?
Please don't worry op - as pp have said the advice in NICE & elsewhere contradicts this finding - please note that one of the first rules of research is that the findings have to be "transferable & reproducible" or words to that effect.

So you think your ability to infer from research and interpret research into medicines is better than your doctors ?

Interesting.

I’m all for doing your own research and being an advocate for your own health but when you’re not a qualified HCP, it can really create a lot of anxiety when you search for all the bad bits. You need to look at the other side of the coin as well and think about all the evidence that it is safe to use in pregnancy. Obviously no medicine is without risk and a lot of medicines can cause issues with unborn babies...but the chances are so so so so tiny that they still prescribe the medication. The benefits outweigh any small risk

You really shouldn’t be wasting your GPs time with a further appointment for this, sorry.

Your GP is following standard recommendations for pregnancy. New studies are always being conducted and if over time they find significant results advice will be changed.