Any GPs here?

[SilverLinings2014]

On holiday last week with 14 month old DS. He had a nasty cough and could that started worrying me on Wednesday as he began to sound wheezy with it and his lips looked a bit blue.

Took him to the urgent care centre at the local hospital as advised by 111.

The doctor prescribed amoxicillin oral suspension to treat a minor chest infection. So far so good.

Fast forward to now. We are 3.5 days in to treatment. The Amoxicillin doesn't agree with him...tummy ache, loose nappies, writhing around in pain and crying...oh so much crying. Last night was our worst ever; I saw every hour at least twice.

I'm struggling to understand how long this course of meds is supposed to be. I'm sure the doctor said 5 days but that isn't stated on the bottle, it just says "complete to course. Discard any remaining medicine".
The bottle is 100ml, enough for twenty 5ml doses, which is almost 7 days.

Obviously I don't want to inadvertently stop part way through the course, but also I don't want poor DS to suffer any longer than he has to with an upset tummy.

Obviously I will check with our GP in the morning but does anyone with any experience of Amoxicillin know of it's usually a 5 day course for children?

TIA

Amoxicillian is usually a 7 day course in my experience with it, especially for a chest infection. 5 day courses are normally for things like ear infections. Is this his first time taking antibiotics? He could easily have an allergy to it. However antibiotics can just cause loose bowels in some children. I would speak to a pharmacist or your gp again tomorrow. I know how awful it is when they just cry all damn night and nothing soothes them especially when they can't talk to you. you just feel so helpless and tired, you have my full sympathy. Distraction is probably your best bet, even in the middle of the night, some quiet cartoons on YouTube or a quiet favourite toy.

I had a 5 day course for a chest infection, prescribed by a doctor in hospital. It was a massive dose so no idea of that's why it was shorter but was definitely 5 days.

It's a 7 day course, but one bottle doesn't give enough doses for 7 days. The chemist should give 2 bottles, but I've had to tell them every time that one bottle doesn't give a full 7 day course. Then they give me the 2nd bottle.

lougle I have always wondered about this as I've always thought the bottle is short at least one or sometimes two doses towards the end!

dottygiraffe hi! ☺️

Nogodsnomasters hi!

How ridiculous about the amounts! Particularly with the whole "finish the course" requirements.

I know, you'd think wouldn't you?!

@nogodsnomasters it's bound to be, isn't it? The powder in the bottle had to be reconstituted with an exact amount of water (84 ml) to make 100 ml of solution at the correct strength.

21 doses is 105 ml. Then, taking into account the fact that people may fill the spoon to the brim, some may overspill, some goes in the lid etc., over the course of 21 doses there will be a few ml lost. So you're down to 19/20 doses right from the beginning.

lougle I have absolutely never thought of it in such depth before but you're completely right, you'd think the pharmacists would be fully aware of this and do what's needed to fulfil the full 21 doses.

It's a 7 day course, but one bottle doesn't give enough doses for 7 days. The chemist should give 2 bottles, but I've had to tell them every time that one bottle doesn't give a full 7 day course. Then they give me the 2nd bottle.

A pharmacist can't give a different amount to what the Doctor prescribes.

Accepted standard is 100mls.

"A pharmacist can't give a different amount to what the Doctor prescribes.

Accepted standard is 100mls."

If the doctor writes "100ml", that's fine. But if they write "Amoxicillin 125 mg TDS for seven days" then the pharmacist should, and can, give 2 bottles to fulfil that prescription (with an instruction to discard unused suspension at the end of the course).

They can't Lougle the pricing authority won't pay for it.

Then my pharmacy has made a loss.

Unfortunately a lot of pharmacies are not making much money these days.

They will give 2 bottles as good customer service. Although the Drug Tariff does state they will pay for the number of full bottles over the number of required doses it's custom and practice that you don't claim a full bottle for 5mls.

I get your point somewhere, but then the prescribing needs to be altered so patients aren't put in the impossible situation of being warned to "finish the whole course", while being told that a course is 3 X per day for 7 days, and then not being supplied enough of the drug to comply with that.

There is massive media campaigning to encourage people to 'Finish the whole course and avoid antibiotic resistance'. How can we expect patients to know that it's 'Finish the whole course unless you haven't been given enough, in which case just finish it when you get to the end of the bottle.'?

I’m shocked at that tbh. I’ve often wondered why it seemed short. Doesn’t that defeat the reason why you need a full course?