To think GP’s are meant to be lenient with prescribing antibiotics?

[Gem123J]

My DD (4 years old) woke up this morning with a headache, checked her temp and it was 38.6 so gave her calpol at 8am. Couple of hours later she was still complaining of a headache and said her forehead was hot so checked her and she was 39.3 so gave her ibuprofen at around 11am. Checked her temp again before we left the house to go for a walk and she was 38.6 and was happy in herself so we carried on with the walk. While on the walk she was totally fine, happy and running around playing “monsters”! We went for a drive and around 3pm she was very pale, lethargic and just wanted to cuddle and wasn’t herself at all, checked her temp and it was back up and was now 40.1 so gave her calpol and decided to call 111 because she was also complaining of sore throat, headache seemed to be bothering her more because she was wincing and she was also complaining of belly ache, her tonsils look inflamed too. We stripped her down and had a call back off the triage nurse, then the GP and was told to come in for an out of hours GP appointment later in the evening. While waiting for the call back her temp went up to 40.2 and we gave her ibuprofen at 5.30pm.

She didn’t want anything to eat but she did manage to drink and had 2 of the baby cucumbers but didn’t want anything else. Her temp went down with the ibuprofen like it had done earlier. She perked up a bit before the appointment and her temp went down to 38.6 and the GP checked her lungs, checked her ears and her mouth but didn’t seem to be concerned about her tonsils and just said it’s most likely viral.

I am obviously a bit concerned because her temp had got so high even with alternating calpol/ibuprofen every 2-3 hours (we were told to alternate off her GP last time she had a high temp that was still rising last year). And there have been local cases of strep a and I thought that GP’s were told to have a low threshold for prescribing antibiotics because viral and bacterial infection symptoms are indistinguishable in the very beginning.

Obviously I’m going to keep a close eye on her tonight but it is a bit scary when you read stories of children who were told they had a viral infection and were seriously ill a few hours later. My friend took her son to their GP last week and was told he had a viral infection, she wasn’t happy with the response and had husband to take him the following day and they swabbed him and prescribed antibiotics and it came back as strep a. I know not all cases are fatal but should I have pushed for the GP to take a swab? All he said was keep an eye out and if she still has a high temp in 5 days to take her back. Has anyone experienced the same thing lately?

Obviously if I thought my daughter was seriously unwell then I wouldn’t be waiting around, it’s just crazy how one minute she looks absolutely awful, but perks up and looks like a different child the next and is just up and down like that!

Completely and utterly OT and I hope your dd gets better soon, but do people still 'go for a drive'?! I thought it was something people did 50+ years ago before we knew about global warming or for very elderly people who can't otherwise get out. I honestly don't think I've ever gone for a drive just for the sake of it. Or have I misunderstood?

I questioned it yes.
As a GP would also have, had the OP had the initial conversation with them about this.

OP hasn’t followed at home instructions for treating these kinds of bugs. I am going to hazard a guess she has read what she wants to read rather than following what would have been the suggested standard treatment plan by her GP under these circumstances.

@possomcandle

thank you. As a parent and seeing all the fatal cases you do worry don’t you. Thankfully she is fine in herself this morning, as she was yesterday but obviously took a funny turn. I will keep a close eye on her and if she is still unwell tomorrow I might take her to see our GP but hopefully she’ll be fine and won’t need to go in.

I don’t think it’s fair for parents to be made to feel guilty about being concerned of their children, I’m sure there are some parents of the 25 who have passed away recently who might feel like they should have done more, I know I would, even if I did try my best. But I also understand the media like to scare us so I’ll just be playing it by ear and hoping for the best.

I wouldn’t like you as my doctor @Quincythequince !

OP I also saw plenty of coverage about having a low threshold to treat with ABx and it’s a bit surprising that (supposedly) a doctor has no idea of this, irrespective of their speciality.

I also think you question is reasonable in the circumstances, and you are getting a hard time. As a worried mum, it’s fine to ask questions, and I don’t think you have “demanded antibiotics”, but just querying the situation.

Having said this, I also think if your child has been examined and felt no meds required I would be reassured by this. The fact they are happy and playing when the temp goes down is a good sign.

I followed this which was sent to me by the headteacher of DD’s school several weeks ago. What advice should I follow since you seem to know better?

I don’t judge you for making a judgment call to go out for some fresh air. But the fact that she was well enough to (even if tired afterwards) is a positive sign that she is coping ok with fighting whatever bug it is off.

hopefully a couple of days of rest and she will bounce back

You don't have to explain yourself OP. This is a prime example of one person initially picking up on an inconsequencial detail to be a smart arse and then others following suit like a little gang of sheep as they think it makes them seem clever. Typical mumsnet behaviour.

It's not clever to berate and try to pick apart a concerned mum who is worried about their child. If I were you I'd leave this thread and you're bound to just get more of the same.

OP you should be concerned about your child’s care and shouldn’t ever feel
guilty. Nobody has said that.

But your thread title said this

‘To think GP’s are meant to be lenient with prescribing antibiotics?’

This isn’t the same thing tbh.

Just keep dosing regularly with paracetamol/brufen for now and keep an eye on her. Obviously go back if any major concerns, but from the sound of it, she sounds like she’s doing ok.

@Quincythequince

oh and following the above, I then followed the advice of 111 Wales (as was advised to call from the above), and then followed the advice of the Triage Nurse who called me back, then followed the advice of the on call GP over the phone who made an appointment because he thought it was necessary to see DD face to face. And then I did actually follow the advice of that GP, I just simply created this post to share my concerns given the information I had read elsewhere, and wanted to know if anyone else had experienced something similar and what they did about it.

With the shortage of antibiotics at the moment, there is no way I'd want my 2 boys prescribed antibiotics on a low threshold "just in case" that then meant a child who needed those antibiotics couldn't get them.
Deal with the symptoms as they present and make a judgement as to whether things have changed and need reassessing.
Keep her warm, not out walking, let her rest and allow her body to fight it off.

I know exactly what a low threshold is.
What I asked is where the OP saw this information. What is communicated to (and understood by) healthcare professionals is a very different thing to what the average layperson may read and rely on.

Any doctor if a patient comes in saying they read something about something, would ask where they read it, if it had a grain of truth in it.

As has been pointed out by a completely different poster, a key part of that text was left out by the OP (in terms of specific symptoms which warranted prescribing).

Yes that was the title, not because I personally thought they should be more lenient, because that is what I had read. Maybe I should have titled it differently, but if other pp’s gave me the chance to explain that it’s not MY opinion, it’s what has been said on the news, instead of throwing me into the lions den and making so many assumptions about me then maybe they would have seen my intentions in the post.

Last week I took numerous calls about cough and cold symptoms. Most of these people had been prescribed antibiotics which were nearly finished or had just only finished and they had the same symptoms.

Perhaps they didn't need antibiotics in the first place as they wouldn't have helped.

We live in an "Amazon Prime" world where we want it now and we get it straight away. In other words antibiotics are not magic and coughs and colds, no matter how rotten they make you feel sometimes we need to ride them out.

Fair enough OP. I am not going to dispute that. But your thread title doesn’t represent what you’re saying to wanted to achieve here, and many people, myself included, have answered accordingly.

Unfortunately she wasn’t just tired after, her temp had shot up to 40.2 even with regular calpol and ibuprofen, that’s when I decided to call 111 as per advice sent out via NHS Wales. But she does seem to be better today, thank you. I’ll keep an eye out and try and keep her temp down as much as possible.

Answered to the title only, by making assumptions and berating someone without even considering what they actually meant.

This just shows the negative impact of the media whipping up hysteria creates. It makes it hard for even normally rational people to not panic when really there is no cause for panic.

you where sensible and got medical advice. From how she was presenting they gave advice which as she seems better this morning seems it was spot on.

I had this a couple of weeks ago. GP saw DS in the surgery for an urgent same-day appointment and said 'he's on the borderline for needing antibiotics' due to flushed complexion and very high fever (over 103). I said, in that case why not prescribe them and I can start straight away if he deteriorates or develops a rash, but won't give them otherwise. She said, 'because there's a national shortage and someone else might need them more'.

She obviously felt concerned because she rang back to check on him (unheard of at my GPs) twice the following morning. He seemed somewhat better in himself but had small red spots on his tongue, so she prescribe adult amoxicillin which I was eventually able (after trying a few pharmacies) to get, but only one box for a ten-day course. Weirdly the pharmacist seemed to be trying to encourage me not to take it by saying that she had prescribed a 'very high dose'.

By the time I got home from that expedition, his fever had come down. So watched and waited and in the end didn't use the medicine. After Christmas I will see if the pharmacy want it returned. (If they can't reuse it, I will keep it for future emergencies.)

I don't think the walk was that bad an idea. But my point of disagreement with previous posters is about the fever. With a low-grade fever and no additionally painful symptoms (eg headache, very sore throat) it is nuts to give large alternating doses of antipyretics. The fever is the body's method of fighting the virus, because viruses find it harder to survive at higher temperatures. It may also stimulate the immune system. Children are very good at running fevers, and older people rarely have very high temperatures. I only gave Calpol twice recently to DS, when fever was over 103. (Also think you're right to continually be monitoring the temperature; otherwise you don't have enough information.) After two days of being ill he was completely better.

OP, honestly.

You have had plenty of chances to explain yourself. The constant ‘but but but’ by way of defending what is arguably a misplaced thread, is a bit much and now a title thread that doesn’t reflect your views?!

What kind of response did you expect?

Please keep your child dosed at regular intervals, fluids up, keep her warm and let her rest.

Once you’ve done that for a couple of days, re-assess but of course take her in again immediately if any proper concerns.

There is an extremely horrid virus going around, which is rampant this year and very long-lasting. You will have come across mention of this in your reading also I imagine.

Can last up to 4 weeks, although tends not to be as long in children. Accompanied by a terrible cough, and earache too. So Be mindful of this too.

OP. You were not berated.
Your lack of administering proper, basic care (lots of people don’t, I would t worry too much about it) in the same breath as demanding antibiotics is the problem there.

You need to consider this when either creating a thread like this, or calling into question the credibility of an entire profession based on an article you read.

I’m not even a GP. But the GP bashing on MN is generally pretty appalling.

I work in healthcare

Judging by your posts here, unless you work in a hospital canteen, this is pretty concerning.

There were additional symptoms and I explained this in my OP. She had a headache, later on complained of a sore throat, her tonsils were inflamed.

I don’t know if many have missed that. Obviously the GP saw her face to face and said most likely that it was viral so I will just keep an eye out on her. His advice was to keep on top of calpol and ibuprofen and look out for any rashes and he did say call back if I was concerned.

On a side note - I will never come to Mumsnet with any concerns anymore, your post has been fine and thank you @hopsalong, and I’m glad your DS was fine in the end.

And why is that exactly? Why are you concerned if I work in healthcare regarding my posts?

Lack of administering proper, basic care..? What do you mean? Where has there been a lack of basic care, is this another assumption? I don’t believe for one second I’ve done that.

No, OP.
Again, not what happened.
I read your OP, and I questioned various aspects of it.

Clear consideration as to trying to understand what you’ve done.

You were wrong here in your initial assertion, OP.

Just move on.

And again, what aspect of healthcare do you work in?

Yet you say your got the advice communicated by a HT?!