To think a GP doesn't understand antibiotics

[FakePlanet]

I mean of course she would right?

Two days ago woke up and had such pain in back of my throat. My baby has had a bad cold recently. But my throat was swollen and eating and drinking hard

Went to GP. Confirmed tonsillitis and lots of inflammation

She then went onto a website and put in my symptoms and prescribed 10 days of antibiotics

I said but I thought most tonsillitis was caused by virus so antibiotics wouldn't work. she said she'd looked online and antibiotics were right way to go.

I have started taking them but the more I read online the more it's clear that antibiotics really aren't effective for majority of tonsillitis

Am I being an Internet idiot? Surely GP is right? But I'm sure I've just caught a cold virus off the baby and it's developed into tonsillitis but GP didn't listen and just kept saying the website said antibiotics

There’s templates we follow that are attached to your notes that we put your symptoms in, this then indicates whether abx, delayed abx or does not require abx.
It’s the microbial prescribing guidelines, maybe that is what she was using rather than just google 🙄

GPs will often look up conditions and medications on a database during your appointment. She's not just googling it/ 'looking it up online'.

If you've been prescribed antibiotics and have started taking them then you need to finish the course. Not doing so can result in antibiotic resistance and they will be less effective if you need them in future.

If you had doubts you shouldn't really have started them.

You might have bacterial tonsilitis anyway so it might well help.

@MissTrip82 Fair enough

Five times a day - really? There are no oral antibiotics give 5 times a day.

Five times a day on an empty stomach.

That's a weird one - five times a day is an awful lot, usually it is three times. And doing that on a truly empty stomach is going to be almost impossible to achieve and be able to eat...

You sound like you've got v little confidence in your gp after this and the prescription for depression (which also sounds odd to me FWIW)... could you move GP practices for the future?

tonsillitis is not one single pathogen
and trust the gp with years of medical training instead of google

Where I work we use the centor criteria to determine whether antibiotics are appropriate for tonsillitis. It's scored out of 4 points, and if you have 3 or more then there is a reasonable enough chance of bacterial infection to justify antibiotic use. The criteria are;

• Absence of a cough +1 point
• Presence of white spots on tonsils +1 point
• Enlarged cervical lymph nodes +1 point
• Fever +1 point

So it's possible she did this assessment in her head and established that antibiotics were appropriate. It's also possible she just did a slapdash job and threw an antibiotic at you.

I don't agree with other posters disparaging the GP for looking something up however. Local guidelines and prescribing formularies vary around the country and based on local antibiotic sensitivities. I would always want my GP to do their due diligence and check guidelines for anything they are not entirely sure about, rather than being too proud and feeling they should already know everything off the top of their head.

You should have just left it a while, self care to see if it was self limiting rather than having a GP appt and then expecting them to carry out a laboratory test before then prescribing you a med if needed. We have such limited funding for nhs at mo, and so many virus’s going around while are self limiting. I think it’s unreasonable to be carrying out testing on everyone as soon as they feel ill. I suspect if it was a virus you likely wouldn’t have made a GP appt unless you’re attending the GP for every little thing so if there’s no history of you being a regular attender at GP then I think it’s fair to presume it’s bad and Abs warranted. Although by your response to the Abs I’m wondering whether your symptoms aren’t that bad at all and you probably wasted a rare GP appt

We use FeverPain score (I complete the online proforma when with a patient) It gives us a risk of the infection being bacterial eg if you meet all the criteria then it gives you a risk score of 62-65% from memory. So this is the percentage of the throat infection being caused by a bacteria. I explain this the the patient and say we may be giving an unnecessary course of ABx. Most people score lower than this and we usually agree to do a delayed prescription or no prescription at all. Hope you feel better soon.

OK OK. I'm being a dick. Can I blame lack of sleep/feeling v unwell/not eating/getting my period all in the last few days?

I'm confused. Why does it matter if you've never had tonsillitis before? There is no limit to the amount of times you can get it.

GPs do not prescribe antibiotics lightly these days. If its bacterial tonsillitis you need to take the whole course.

I guess she thought there was a chance it’s bacterial.

I’ve had tonsillitis many many times and my GP once told me there is a scoring system they use to decide if you need antibiotics.

• Did it start suddenly (no cold or other illness before)
• Do you have a temperature
• Are there white patches in your throat

If you score yes for two of these than he will prescribe antibiotics. Without testing it can be hard to know for sure if bacterial. Saying that though I’ve also been given antibiotics when I don’t meet this criteria as a ‘just in case’ and held off from taking them unless it gets worse. If you don’t think your tonsillitis is bacterial then hold off taking them and see how it goes. Get dissolvable paracetamol and gargle that, throat sprays are good too. (Although probably best to follow the doctors advice as this is the first time you’ve had it. I get it multiple times a year so know what I’m looking for).

Just please don't start under medicating your baby. This is a cultural sickness not physical matter. A bit like banging saucepans, you think you are taking responsibility for not bothering the lovely NHS while it kills hundreds of people a day. If you want to get second opinions or a quirky lifestyle either move abroad, which I recommend, or earn enough to fund it.

The gp won't be able to,tell if it's bacterial without testing a swab. But this takes time to do and for results to come back. In the meantime, if bacterial, you can become much more poorly quickly.

I've had a nasty case once where I wasn't given ABs. A day later I was hallucinating and in a really bad state. I was given IV ABs to get me sorted out.

My dd has had tonsillitis many times when growing up. They didn't use to give her AB initially but it almost always got much worse, leading to us having to return and take up more gp time. Only once did they swab - it was bacterial. After that they always prescribed ABs.

Never had oral ABs which are 5 times a day though - normally 3 or 4 here got 5, 7 or 10 days,

My son used to suffer with tonsillitis a lot, always got antibiotics and always worked!

So you basically wasted a valuable doctor's appointment? You didn't think you needed anything prescribed but you went anyway? What's the point.

You had a sore throat for 2 days, managed to get through to your GP surgery, get an in person appointment and a prescription? You can't possibly be in the UK.
I've suffered dozens of bouts of tonsillitis and am never given antibiotics until I've had it for over a week 'to see if it's viral'.

I’m subject to tonsillitis…I’d kill for antibiotics when I have it!!

Or you could blame having tonsillitis which would got better rapidly if you’d taken those antibiotics!

I used to get recurrent tonsillitis and often had problems getting antibiotics because the GPS always said ‘it’s usually viral’. However, antibiotics were the ONLY thing that ever cleared it up, so it was obviously bacterial.

I’d persist with what you’ve been prescribed.

GPs are humans and not all are great at their jobs. I had a GP prescribe me antibiotics for a sore throat when I had covid. I didn’t take them and the sore throat was gone in 3 days. It was the worst sore throat I have ever had but it was clear my sore throat was a symptom of covid. I think some feel that they need to give you something but handing out antibiotics like candy is terrible in the long run.

Unless they swab which they don't do neither they or you will know if it's viral or bacterial. You have a severe sore throat,take the anti B's.

Very few GPs 'hand out antibiotics like candy' 🙄

I had bacterial tonsillitis (confirmed by blood test) and it was horrendous. GP kept fobbing me off as I didn't have a fever and the website you're talking about advised to 'wait and see' so it's obviously not 100% accurate. I'd hold on to the antibiotics and take them if you start feeling worse.

I mean giving you something at the end of the appointment so you leave happy like giving candy to children. They want patients to leave feeling they did something and so they prescribe antibiotics for things that could or are viral. Not all GPS but some GPs. Does OPs GP know for sure she has a bacterial infection that requires antibiotics? Without blood work or a swab? Being able to eyeball a red inflamed tonsil and determine viral or bacterial infection is quite a skill.