To refuse to take DD back into the GP surgery?

[Madeline637]

DD has been unwell for a week - fever and cough that’s got progressively worse and is now productive with phlegm and mucus. We have seen 3 GP’s, all said it was viral despite her getting more unwell everyday rather than improving and her never responding to a viral infection like this before.

Last night she deteriorated again and the out of hours GP called an ambulance out because of her breathing and oxygen levels. The ambulance stayed for quite a while, done loads of tests and observations and decided that she was safe enough to stay at home (which was good because DD has autism and really struggles with being in a hospital setting, it’s extremely distressing for her and often takes a few people to manage her behaviour in that setting). The ambulance did however say in the report to our GP that it’s a clear cut chest infection (they listened in to her chest and heard clear crackles) and that she needs antibiotics and it’s not fair that they keep hauling her back to the GP surgery and not giving her the medication that she clearly needs, especially when she finds this distressing.

I got a phone call to say that the GP wants to see her again before thinking about giving medication. AIBU to refuse on the basis that she’s already seen 3 GP’s in the space of a week (the last being on Tuesday), that she’s already been assessed this morning by a medical professional and they’ve told the GP all the information that they need and that DD will find this very distressing given the fact that she’s already been poked and prodded for hours today and having to wait in the surgery itself?

Usually they can prescribe the antibiotics over the phone and this particular doctor I’m not keen on anyway - she ALWAYS messes up the medication, expects you to tell her what diagnosis you have and how to treat it and honestly bloody clueless.

100 day cough is whooping cough. There’s approximately a 1 in 5 chance this can lead to pneumonia. Your GP was not necessarily wrong in their diagnosis. Even as an adult I have had a chest infection that led to pneumonia and there is no real way of predicting who/why/when this happens.

Unfortunately antibiotic resistance is a real, worrying problem. GPs have to be cautious about prescribing them. The fact remains that many, many chest infections are viral and antibiotics are not appropriate.

Good god your poor daughter. That is ridiculous and I’m raging for you. I don’t blame you not wanting to bring her in. I would ask for a phonecall directly off the gp rather than the reception and say what you have said here. You have every right to be unhappy. I know viral infections can progress to an extra infection on top being bacterial, but this sounds like your poor little girl needed antibiotics from the start. It’s so disheartening. We have had this before too where it took a few trips and indeed it was bacterial and once she started the medication it went!

crackles don't necessarily mean a bacterial infection though so the GP's not being unreasonable in wanting to assess themselves before they take responsibility for prescribing for a child. Also, if the paramedic thought she had a bacterial infection they should probably have organised managing that appropriately overnight.

I'd say that the key thing is to get her the antibiotics rather than arguing about it

I can totally understand your anger and frustration but if you want the meds you're going to have to take her in.

The OP's daughter has only been ill for a week. None of what she has posted indicates that the infection was anything but viral. Three doctors have diagnosed that it is viral. Paramedics are not doctors.

But sure, you, a stranger on the internet, can diagnose her! You get that antibiotics don't work on viruses, right?

Could they do a home visit to mitigate the distress as a reasonable adjustment for your DD's needs?

Hearing crackles doesn't mean it's a bacterial infection, viral infections can cause crackles and antibiotics don't cure viral infections. Of course the dr needs to see them before prescribing. The ambulance staff are amazing but aren't drs so cannot tell the difference between a virus and a bacterial infection, only tests can confirm that

Paramedic recently rightly worked out that DS had pneumonia. He ended up in hospital. I'd be down to the GP in record time for antibiotics having seen for myself how nasty the current cough going around can get. I have ND DC too so I get that it's not easy.

Another one saying do what you need to do to get the antibiotics and argue the toss afterwards.

It’s not unreasonable for a HCP to want to perform their own examination rather than relying on the findings of another to administer meds. When I’m called to a GP surgery for a patient with chest pain for example, I’m still going to do my own assessment of the patient and make my own decision on the meds I am going to give and the correct location to convey them to regardless of what the GP has written / handed over.

Conditions can change / evolve quick quickly so what was noted 2 days ago was likely correct for 2 days ago.

The issue is, no new antibiotics have been developed since the 80’s. So when we all become resistant to the current antibiotics, we are screwed.
So the 3 GP’s decided to err on the side of caution instead of giving out unnecessary antibiotics.
Now they feel she may need them, take her back to the GP.

As a mother of a child with Autism, Id still say take them in

Well yabu Dr's say viral come back if you get worse etc. She has got worse. Gp may wanna rule out a puemothorax, puemonia etc yes I have a child with adhd and emotional dysregulation

YANBU, I had similar and just refused until they prescribed over the phone.

GPs can and do prescribe over the phone for antibiotics.

The majority of chest infections are viral.

Antibiotics may not do anything.

Hey @Madeline637 how is your girl today? Did you get antis? X