No liquid antibiotics for 3 year old

[ineedastrongercoffee]

My DD3 cannot have penicillin, we managed to see the GP yesterday for Tonsillitis. She was given clarithromycin, absolutely no pharmacy in our area has this in stock. I spent over an hour in the GP surgery yesterday ringing around pharmacies up to 25 miles away. No one has this in stock. I also asked what non penicillin antibiotics they have - answer was next to nothing.

I ended up managing to get clarithromycin tablets which I need to half and crush up. I've managed to do this so far by adding it to Calpol and a fair amount of bribery.

It just makes me so sad that this is the situation we are in. I feel very lucky that DD has taken this so well, but my other DD3 (they are twins) would definitely not be as compliant. It must taste absolutely vile.

I know that everyone is stretched right now. The Doctors in our area have the monopoly on all GP surgeries in our town and also 3 other nearby villages. Why not give me a heads up that I could struggle to get the liquid. I had to waste precious GP time by going back into the surgery to get them to alter the prescription for the tablets.

Now if it was me in charge (don't all laugh at once) I would be contacting all pharmacies in the area and asking them to report first thing in the morning via email, on stock levels of these antibiotics where they have supply issues. The GP's pay the pharmacies for sending prescriptions their way - surely an email first thing will give GP's vital information.

Doesn't solve the supply problem I know.

I feel so sorry for everyone in the NHS at the moment 😢

I had this with penicillin a few days ago. GP put prescription on spine and I had to ring every pharmacy in a 30 mile radius - and did end up driving about 25 miles to get some. I was raging the whole way I'm not gonna lie 🤣 why can't they all report to the GPs so the doctors know where to send the prescription?? I'm with you OP, it's shockingly managed (in some areas).

I crushed it and mixed it with yoghurt, which worked okay, but she's no fool and asked me the next day whether it was normal yoghurt or funny yoghurt 🤣

In the North West pharmacies are reporting what stocks of antibiotics they do and don’t have to the OOH service and presumable GP surgeries too. They’ve also temporarily been given license to issue alternative antibiotics without a new prescription as the shortages are so bad.

why can't they all report to the GPs so the doctors know where to send the prescription?? I'm with you OP, it's shockingly managed (in some areas).

Because there’s no incentive for competing businesses to compromise. Why can’t there be one national pharmaceutical distribution not-for-profit?

Just throwing in other ideas, my gran swore by crushed tabled in a spoon of jam, ideally raspberry as that masks the texture too. Just a teaspoon though so you’re not having to get them to eat loads.

YABU for blaming your GP for this. Most practices are not dispensing, they have no control over what's available in the pharmacies. It sounds like your child was assessed and prescribed the correct treatment, that's as far as they can go. Just another stick to beat GPs with.

GPs do not pay Pharmacies unless they are owned by the GP.

For this to work they would need to report to all GP surgeries each time they dispensed a prescription for antibiotics as the the amount they have available wont be the same all day as it would be when they first reported stock levels in a morning.

Will she take the tablet if you explain to her what to do? I have a 2 (nearly 3) year old who despises calpol so after much demonstrating and practice with smarties I've taught her to swallow half a paracetamol. She's still not wild about the taste but will grudgingly take it if feeling really rotten.

Or get her to chew up a big mouthful of food and shove the tablet into it before she swallows. Reward with much fuss and applause.

The older 2 I give them a closed choice which seems to work. You need this medicine or you won't get better but they didn't have any liquid so what do you want to do? Swallow it whole, really quick or crush it and mix it with something?

Generally they'll just try and swallow it unless it's really rank.

It doesn’t matter if the pharmacies send an email to your GP first thing in the morning - they have no control of how many prescriptions arrive before yours. They also receive deliveries from the wholesalers at different points during the day, so stock may arrive later in the day.
www.e-lfh.org.uk/programmes/kidzmed/
This is helpful for teaching kids (and adults!) how to swallow tablets and capsules.
www.sps.nhs.uk/articles/using-solid-oral-dosage-form-antibiotics-in-children/
This contains specialist advice on giving different antibiotic tablets and capsules to children - not all are suitable for mixing with food etc.
Pharmacists should be able to dispense a different form (e.g. tablets instead of liquid) without getting a new prescription and I believe there is also the option of swapping to a different antibiotic if they have no stock of the one the presciber has asked for - I don’t have experience of this but saw it in the news.
But yeah it’s shit.

I was absolutely not blaming the GP's - I'm saying the whole system is sinking and they need to work together to get through - I had no way of getting my prescription therefore I had to go back to the GP and have the prescription changed and signed again - a waste of everyone's time but especially the GP

It's not a perfect system but at the start of the day you know that every single pharmacy is out of stock of a certain antibiotic and there is no viable liquid alternative - you give the patient a choice - you can say according to our records this isn't in stock within the local area as of this morning - you are free to try and source it yourselves OR we can give you a prescription for a tablet which we know is in stock

the doctors told me yesterday that my nominated pharmacy had to put the prescription back onto the spine as the GP surgery had already allocated payment to that particular pharmacy

IME liquid antibiotic taste foul anyway, so annoying as it is, your Calpol mixture probably isn't any worse

Dissolve the tablet in 5mls of water like the poster above mentioned. It may take about 10 mins to fully dissolve. Then disguise the taste with cordial or similar. It will taste quite bitter so the trick is to give it in as little liquid as possible. Try cordial, a spoonful of yoghurt, fruit purée or flavoured syrup if necessary.

We've managed tablets before snapped in half and embedded in chocolate spread on a teaspoon, one at a time. They can practice first on a "blank" spoon with just the chocolate spread on it.

My kids can do it, with sufficient sweetie rewards. I've been known to do it for myself too!