Should’ve been given antibiotics?

[ineedasleep]

Feeling weak and sorry for myself so be gentle. Warning description of sickness bug below.

I’ve been unwell for nearly 3 weeks. Chesty cough with delightful mucus, swollen and sore throat which is making me choke on my own salvia. Difficulty breathing at night and just unbelievable unwell and in pain. Throwing up due to cough. My body feels like it’s got the flu. I thought it was Bronchitis for 2 weeks and now I think I’ve got Strep throat. (I haven’t been this sick since I had COVID years ago).

Anyway, not to be a fickin martyr but I don’t ever go to the doctors for myself or to get antibiotics as I usually just think ‘I’ll get over this myself’ and I usually do get better but week 3 and I’m not getting better, probably getting worse.

My doctors have changed their appointment system last week and now do a triage with a phone call or seeing a paramedic. So anyway, I call up this morning, get told of the new system and they helped me fill out a triage form and that I’d be contacted by the end of the day. Luckily (or so I thought) I was told to come down to the surgery and see the paramedic this morning.

I haven’t got a car at the moment and so had to get myself and 3 year old in a cab to get to the doctors in time.

The paramedic gave me an examination, told me she could see I was very unwell, I had ‘crackaling’ in my lungs, my throat was very red but not swollen. Though she noted I had mucus she said she couldn’t do anything for me and wouldn’t give me antibiotics.

My face must have been one of disbelief because I was having coughing fits in front of her, gasping for breath and I have no voice left.

She said ‘if at any point you can’t swallow your own salvia or finding it difficult to breathe call 111’. I said ‘but I am finding it difficult to breathe and I can’t swallow my own salvia; I keep drooling’ (which I had told her earlier on in the examination). And she said ‘ok, well when that next happens you’re going to have to go to A&E and get seen by them and get antibiotics there’.

I was so sad. I just explained to her that I have no car, I’m a single parent and I can’t go to the a&e 10 miles away as the wait time is around 8 hours. I have no one who can help to watch my son so that option isn’t feasible considering I thought going to the doctors for antibiotics was the right route, not a&e.

She just gave a sympathetic smile and said there’s nothing she could do.

After trudging back home on the bus, feeling like I’m about to faint and having a forced afternoon nap with my son I’ve woken up like….I really should have antibiotics shouldn’t I? Or am I being dramatic?!

I had a friend in your situation, told by a practice nurse she had a virus and to take paracetamol, ended up at ooh later that night with a Quincey, she was really poorly. I would persist until a doctor has seen you, ask for a second opinion.

You may not need antibiotics if it is a viral infection. That we cannot tell you online.
But how is that you cannot fully swallow your own saliva if it is not swollen?
Surely something is amiss here.
Do you have a temperature?

But correct me if I’m wrong and apologies for the TMI but I’m coughing up tons of green and yellow mucus and then subsequently choking on it and my own saliva and then throwing up, surely the colour of the mucus is a sign of bacterial infection?

The GP was absolutely useless for my sister, she had to go to A&E. that’s when they diagnosed whooping cough and thankfully she is starting to feel better now.

You need to be seen. Maybe I'm an alarmist, but you've been sick for a while and you are getting no treatment at all. Call 111, go to an urgent care, something.

Look up antibmicrobial stewardship

We have to be careful how antibiotics are used. They won't work on viruses

It's now "out of hours".

Could you phone a local pharmacy or nhs24 for advice?

There may be an out of hours service available more locally than A&E?

You can't go on like this. It sounds awful.

Op if you can’t see a doctor tomorrow and a taxi to a&e is £80 I’d be tempted to go private if it’s cheaper. You shouldn’t have to it’s absolutely shite but if you need antibiotics the sooner the better.

The green or yellow mucus means your body is working hard, very hard, to fight the infection.
It does not mean that is viral or bacterial. Though many infections start being viral and then bacteria take the chance to settle in and thrive.
Call 111. I think you need to be seen as struggling to breath and swallow.

OP I had this - exactly as you describe but thankfully got Clarithromycin, an inhaler and steroids as well as a swab taken for testing. Waiting for result of that. The way you were treated today is disgusting so yes, please call again tomorrow and insist on a call back from an actual doctor. I was initially first seen by a nurse practitioner but she was so worried that she got a doctor down to look at me. Once armed with all the above meds I was told not to hesitate to get back in touch should I get any worse - they were clearly very worried about me. I'm on day 5 now and do feel heaps better but still a long way from being well. Thank God our surgery acted fast. I'm so sorry, you weren't treated properly in my opinion but hope you get sorted tomorrow - if not I'd wait until the surgery closes and ring 111.

I have a slight temp now, 38.9, earlier at the doctors it was 37.9 she even said my throat wasn’t swollen but it definitely is, I can feel it; my neck is so sensitive too (which is exactly where my son wants to rest his head) and it’s too painful to touch.

Even if the paramedic didnt think it was bacterial you're clearly struggling and need some treatment or at least some better advice than go to A&E. As you said you were already there surrounded by a whole surgery of doctors. The paramedic should have at least popped into one to ask if there was more they could do!

Definitely call them again this week or as others have said 111. They usually get a doctor to call you back

And little one is fine now thank you! He had a really hard knock and was acting strangley (hence the trip to A&E and 111 concern) but as soon as we got there he was bouncing off the walls running around poking his head into people's cubicles.... :/

My GP said strep throat is rife at the minute, could be that?

Have you tried the Livi app? I believe if your GP offers this it's free. Otherwise i think there is a charge.

No it's not at all. That's a complete myth. The green/yellow mucous is actually a sign of your immune system doing its job & fighting the infection. It makes no difference if the infection is bacterial or viral.

I am so sorry. I had exactly this a month ago. I was immediately given antibiotics. They listened to my chest and was wheezing. I finished the 5 day course and was still very ill. Went back and I got a second round which did it in the end. Have not had antibiotics in years and so relieved I was given. You need to go back as my immune system would not fight it. Get online private appointment which should be cheaper than your taxis. Good luck.

Hi @ineedasleep you poor thing! This sounds AWFUL. I would be tempted to call 111 and try and get another out of hours GP appt tonight, but appreciate this may be impossible with travel/little one logistics. They can't leave you like this surely?!

You are clearly very poorly. The sore neck is likely to be swollen glands, does it hurt worse if you press lightly with your fingers? Swollen glands will be your body fighting the illness and another sign of how poorly you are. Strefen lozenges are great for sore throats - OTC from a pharmacy and boots have their own version. They are antiseptic and have a numbing effect. Corvonia spray is also great on that front if you can get it.

Don’t they do the CRP pinprick blood tests in the UK?

That is how the GP knows whether to give antibiotics for throat infections etc where I live.

Hope you get some help tomorrow!

Yes, that mirrors my experience. I just bought them online too.

@ineedasleep you definitely need antibiotics and ASAP. Fairly certain you have pneumonia which needs to be treated.

I think they should have at least taken throat swabs to test if it's viral/bacterial because you do sound very unwell!
Also I thought the whole idea is to keep people out of A&E who don't need to be there?!!
Do you have any pharmacist prescribers in your area? Could be worth a trip to see one of them if you're no better in a day or two.
Or of course call your GP back and say you were seen and still not well

They don't know it's viral though do they because they haven't tested

If your symptoms are still worsening at 3 weeks personally I would have thought that would prompt sending a sputum/cxray if they weren't prescribing. Persisting for 3 weeks though can be typical for viral respiratory infections though, not that it's much help! Whether to prescribe or not is a complex nuanced decision based on a lot of detail from your history in addition to the examination. If you're young/otherwise healthy then there's often scope to 'wait and see' - where as with your mother being older/more likely to have other medical concerns the threshold for prescribing would be lower as more at risk of hospitalisation.

Incidentally green sputum, sore swollen throat, crackles on chest can absolutely occur with both viral and bacterial infections. In studies generally between 5-10% of patients presenting in primary care with all of those symptoms would actually have a pneumonia, the other had other conditions. Even those with infiltrate on the chest xray (the 'gold standard of diagnosis) only 65% it's pneumonia/benefiting of antibiotics.

Bronchitis is a viral infection which would cause those exact symptoms. Bacterial infections are not 'worse' per say than viral, covid clearly highlights viral respiratory infections can put people in hospital/be fatal.

My advice for what it's worth as an internet stranger; if you feel like your symptoms are worsening/certainly not improving then book in for a second opinion with one of the GPs. If things are in some way improving and it's more of a frustration about how long it's taking then I'd consider waiting a week to see how things go.

You sound very unwell. Did the paramedic do any observations? Oxygen saturations? Respiratory rate? Blood pressure? Heart rate?

Are you managing to drink? Are you passing urine regularly?

I don’t want to alarm you but is there anyone who can look after dc? What will happen if you need to admitted at any point?