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

don’t take them then OP if you feel you know better. But do know that bacterial tonsilitis won’t go away on its own and can actually turn into what we’ve all been referring to as “strep A” as it’s the same bacteria. I would bear that in mind if you have a small child at home.

it happened to me recently I left it and left it as thought it was just a sore throat but it got so bad I couldn’t swallow properly. I ended up with Strep A and all the antibiotics then needed a second course to properly clear it.

of course a doctor understands antibiotics.

Hey OP, you're allowed to be grumpy. You're poorly.

Some of the keys ways to tell the difference between viral and bacterial tonsillitis are:

Viral - comes on slower, is accompanied by other symptoms- generally runny nose, cough, mild fever, watery eyes and basically feeling like you have a heavy head cold. You can very sore throat but it tends to get better after about 4 days.

Bacterial - comes on quicker, usually but not always would come with a high fever, have severe pain, and there would be an absence of general viral symptoms - it also tends to get worse and worse.

Now that's not a slam dunk way of diagnosising because people can start with a general viral infection that can lead on to a bacterial infection - meaning you'd have the snotty nose too. Some people can have a very severe sore throat with a viral infection. But in an adult anything that comes with a higher fever is usually suspected as more serious, particularly if the fever doesn't really come down or stay down after taking paracetamol or ibuprofen.

I am slightly concerned about the antibiotics and I do think it would be wise for you to look at the leaflet that came with them, or Google them. Most bacterial antibiotics will be prescribed amoxicillian which is 3 a day for 7 days.

5 a day for 10 days seems extreme. But this is generally easy enough to double check online. Alternatively you can ask a pharmacist.

The other way you might know if it's bacterial is whether your symptoms start to resolve quite dramatically within 48hrs after starting the antibiotics. If it's viral the antibiotics will do nothing. If it's bacterial you should get relief quite quickly. So if by Sunday your symptoms are resolved then you know it was bacterial and to continue the course. If by Monday you still feel just as bad - call your GP back, because could be two things - one it's just viral, or she's given you an incompatible antibiotic for the type of bacteria you have and you need a different one.

Bacterial tonsillitis doesn't always come with white spots. It frequently does but not always at first. But if you look on the roof of your mouth and you see red spots (Google images red spots - strep A) then antibiotics would also be given - even if there's no white puss. Red spots don't always mean bacterial but it's a strong indicator for strep A.

I'm not a doctor! But I've had kids and tonsillitis about 15 times over my life - bacterial and viral - so this is a bit of a combination of information I've been given by doctors at various appointments! Hope you feel better soon!

Why did you go to gp if you’re convinced it’s viral, she can’t do anything for viral.

I thought you should wait a bit to see if it clears up on its own before starting antibiotics. The GP once prescribed my attention seeking mother antibiotics over the phone for a chest infection, she has a cold.

Im unsure why they are prescribing antibiotics so freely when we as a society are becoming immune to them.

I would also really be untrusting if a GP that needed to google how to treat tonsillitis… eh???

Its well known in the NHS peofessio al world that GP over prescribe antibiotics. They do it because its safer for them and mean it stops the patient possibly coming back. They also do it under pressure from patients who would argue for hours (and xi plain) if not handed them.

The impact of the population losing the positive impact of antibiotics is well known and adds significant pressure on the nhs.

@Irritateandunreasonable they don’t Google it ffs they have different sites that GP use as previous posters have stated that show different scores for things seeing as they can’t keep every single condition and all its varying symptoms in their head at all times.

jesus this site sometimes

Good god I bet the Dr's eyes nearly rolled out of their head with that nugget of info, what treatment did you want for your virus tonsillitis?

Of course you can't. You're an adult, start taking responsibility for your own actions.

Why did you bother going to the GP

That's not pathognomonic of bacterial vs viral tonsillitis, many studies have shown that it's just as common in viral infections so that statement is about 20+ years out date.

There's been a significant rise in bacterial upper respiratory tract infections of all varieties. Even if something starts as a viral infection, you can get a secondary bacterial infection in addition. If I've gone to the effort of going to the GP, I'd follow their advice, even if, as has recently happened, they hadn't even been born yet when I started medical school myself.

I couldn't swallow so I was hoping for a numbing spray or a medicated mouthwash or something to make swallowing possible. I did get a prescription for that as well and used it and it did help slightly.

Are you ok love? I’ve literally seen a GP use google, fairly new GP but still.

It’s tonsillitis - my 11 year old could diagnose it 🤣

GPs cannot remember absolutely everything, every drug formulation and dosage and know it off the top of their head. They have resources available to them during appointments (specific websites). She didn't just randomly google treatment for tonsillitis.

With strep a (which can cause tonsillitis) being a problem recently she may be be taking a more cautious approach. I've had antibiotics for tonsillitis before, diagnosed just from a GP visual exam of my throat.

Why didnt you just go to the chemist and buy it then?

Honestly no wonder I cant get an appointment when I want one.

ABs worked like a dream on my tonsillitis but if you didn't want ABs why go to the doctors in the first place! What were you expecting to happen?

Exactly!

I mean Boots sell those no need to bother a Gp when a pharmacist could give you these,

If there’s white stuff in your tonsils it’s generally bacterial. I think what happens is most tonsillitis is viral but when your tonsils are inflamed it’s much easier for bacteria to settle in and you have a secondary bacterial infection which needs antibiotics.

My GP says some people once they’ve had a nasty bout of tonsillitis have permanently inflamed tonsils which make them much prone to bacterial tonsillitis. My eldest used to develop bacterial tonsillitis quite a lot although he uses an anti bacterial mouthwash now which has helped. I was the same as a teenager and had them whipped out at 16.

Because I had another covid related symptom that I needed assessed but unreated to my sore throat and antibiotics.

Local infection and resistance to antibiotic therapy patterns change, so for things like tonsillitis, there's often a locally maintained website to score symptoms, decide whether to prescribe an antibiotic and of so, which one (it's not always a penicillin, and it won't be bog standard pen V either, it will be a "penicillin type" antibiotic).

Massive drip feed because the thread isn't going the way you wanted.

This is actually an issue that has been researched pretty extensively. For those of you who don't believe that overprescribing of antibiotics is an issue, you can find mnay studies that talk about the issue on Google Scholar. Here is one that is UK based.

"Overprescribing of antibiotics in primary care is one of the important drivers of antimicrobial resistance (AMR) internationally.1 Previous studies estimated that one-fifth to one-third of UK antibiotic prescriptions in primary care are unnecessary or inappropriate.2 The study by van Staa and colleagues3 published in this issue of BMJ Quality & Safety delivers additional insights into prescribing practices by primary care physicians (general practitioners, GPs) in the UK. Analysing data from more than 6000 GPs in 466 general practices between 2012 and 2017, they found large variability in prescribing practices as measured, for example, by the overall antibiotic prescribing rate per consultation, the percentage of patients receiving repeat prescriptions and the use of broad-spectrum antibiotics. The percentage of repeat prescriptions (ie, antibiotics that were prescribed within 30 days of another antibiotic prescription) ranged from 13.1% to 34.3%, with a mean of 23.2%."

https://qualitysafety.bmj.com/content/31/11/782

Regarding "she went into a website" she would have been looking at clinical guidelines and protocols, not just Googling. Back in the day she would have looked in a book, or maybe at index cards.

Glad you've accepted you were being a dick, OP. I'm curious which abx you're on though?

I used to get tonsillitis a lot and it was always bacterial. Often the GP would not give me antibiotics as they suspected viral but I would get incredibly poorly and need antibiotics to clear it

I don’t dispute there is an issue with over prescribing. We get prescribed antibiotics for our three year old at the drop of a hat it seems. But I think they are more cautious with small children especially after Covid when a lot of usual viral infections have turned into secondary bacterial infections commonly / in our case anyway.

I just think it’s ridiculous that the OP was suggesting all the GP did was look it up on the internet as though they had no further qualification than she did. And to the poster who saw a doctor google, I can’t argue that because I wasn’t there but every doctor I’ve been to that has looked something up it’s been on specialist clinical scoring sites.

I developed psoriasis after several bouts of sore throat in a year with no prescription. I've a lot of aoubt about your post tbh