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Why do Drs not give out antibiotics now without a big fight?

24 replies

CheeryCherry · 28/01/2011 10:23

Have been getting tonsillitis 4 or 5 times a year since I was a teenager, have usually battled out the first few days then gone to Dr for antibiotics.
Now when I get it -like this week- they say its viral, and I should leave it to go away on its own. Why? I can hardly swallow, its so painful and I cannot speak. Sad

OP posts:
topsi · 28/01/2011 11:08

they will only prescribe ab if they feel that it is a bacterial infection that won't clear on its own. If you have had a temperature or there is pus on the tonsils then they might prescribe, or if it is getting no better after about a week.
Over prescribing ab leads to resistance in the bacteria and you could end up with an infection that will be more difficult to treat.
If you are getting no better then go back.

CheeryCherry · 28/01/2011 11:36

Thanks Topsi but how can you tell if it is bacterial or viral? A week is an awful long time to have a throat feeling like this.

OP posts:
ppeatfruit · 28/01/2011 12:56

try gargling with t tree oil and the best echinacea you can afford take 3 times a day and or liguidise a garlic clove with fresh lemon juice. I never get sore throats now i don't eat dairy.

AnnieLobeseder · 28/01/2011 12:59

Because years of doctors handing out antibiotics willy-nilly, and people not finishing the course has allowed bacteria to become stronger and develop resistance to many antibiotics. Superbugs such as MRSA have come about because of over-use of antibiotics. It's a real threat that one day all antibiotics we currently have will be useless.

ppeatfruit · 28/01/2011 13:04

yes annie also there are now strains of pneumonia which are resistant to A.B.s Shock

Karia · 28/01/2011 13:09

If your doctor says its viral, then antibiotics unfortunately won't help anyway.

herdingcats · 28/01/2011 13:10

Go to my Gp then ,I have now got AB's ,when I have not been seen by him ar asked for them !!

ppeatfruit · 28/01/2011 15:09

They sell them over the counter in mid europe!!

AnnieLobeseder · 28/01/2011 16:47

ppeatfruit - as a microbiologist, I'm beyond horrified at the implications of this!

midnightexpress · 28/01/2011 16:50

I was told the other day that there has been a 10% decrease in the prescribing of ABs in this area (Scotland) in the last few months. I think that there has actually been some sort of directive to docs to prescribe fewer ABs, for the reasons already mentioned.

notapizzaeater · 28/01/2011 16:54

Saw Amoxicillin for sale in the supermarket in Mexico ...

I hate taking AB's (in fact was over 7 years ago) cos I always get bloody thrush ....

GrimmaTheNome · 28/01/2011 17:02

how can you tell if it is bacterial or viral?

I don't know if this is a hard-and-fast rule, but our DD had bacterial tonsillitis a couple of years running. We noticed the first time her breath had a quite distinctive nasty odour. When we got a whiff the next time round, we were sure it was the same - the Dr wouldn't prescribe ABs immediately (for the entirely sensible reasons mentioned), but when we took her back the next day he was evidently convinced and she got ABs. Not sure if the tonsils looked pus-y or something.

Did you ask the doctor how they tell? If not, remember to next time. They aren't just being mean, inappropriate AB prescription really is something they are right to avoid.

Lougle · 28/01/2011 17:26

Antibiotics only work on bacterial infections.

People are notorious for treating something when they feel bad. Typically, they start to feel better 48-72 hours after starting antibiotics, and because they are feeling better they stop, or they simply forget.

What then happens is that the bacteria can multiply again, and much like the effect of a vaccination given to protect humans, the antibiotics act as a 'vaccination' - they are like a practice for the bacteria. They get stronger, and they become 'resistant' to the antibiotics. Not immune, but because they are 'resistant' they can survive long enough to multiply. Even if a few die off, the multiplication is 'exponenitial'. ie. instead of getting 2, then 4, then 6, then 8 bacteria, you get 2 then 4, then 8, then 16, then 32, then 64, then 128, then 256, then 512, then 1024, then 2048, 4056, etc.

So imagine a bacteria that multiplies every 30 minutes. Within 6 hours you have 4056 bacterial cells which originated from that 1 cell.

With resistant bacteria, the killing off is slowed, and they get killed slower than they multiply, so you can't get rid of them quick enough.

What happens then, is that you have to use less common antibiotics. But the side effects are stronger, and people still do what they did before. Those antibiotics become useless too.

There were real concerns some years ago, that the number of truly effective abx is reducing so far, that serious illnesses will become virtually untreatable.

Even high-grade antibiotics such as Gentamycin and Vancomycin now have bacteria which resist them.

alypaly · 28/01/2011 17:29

gargle with soluble aspirin and spit it out as long as you are ok with aspirin.its a really good anti inflammatory

GrimmaTheNome · 28/01/2011 17:37

Yes, Lougle is right: if you do get prescribed ABs finish the course. Even if its your DC who kicks and screams every time!

Buda · 28/01/2011 17:53

Manuka honey is supposed to be good for sore throats too CheeryCherry.

Very interesting explanation there Lougle. I might just print that off!

I have probably had antibs about 10 times in my life (am 46) and for the first time ever I didnt complete a course last October. Was prescribed them for a chest infection which had come and gone 3 times or so over a few months so doc gave me antibs. She also prescribed something to boost my immune system. And a probiotic. (Private healthcare and am in Eastern Europe.) Anyway - after a few days I developed a reaction to something I was taking. Got very itchy - palms of hands, small of back etc. I was travelling at the time so went to a pharmacist and took some antihistamines. Presumably in that case I was right to stop taking them?

ilovemyhens · 28/01/2011 18:16

Get some Tyrozets and gargle with either TCP or salt water.

Buda · 28/01/2011 18:26

Tyrozets! I'd forgotten about them. I love them! Weird I know! My Grandad always had them and they remind me of him.

CheeryCherry · 28/01/2011 19:22

Thanks for all these answers, my tonsils do have the usual white spots on, still not certain how they know if its viral or not. I know I should have asked, but I could barely speak as it was1 And gagged inelegantly when he stuck his proddy thing in my mouth Blush I know I should gargle more, think I was feeling sorry for myself. Will look into Tyrozets- the name seems familiar.

OP posts:
A1980 · 28/01/2011 23:13

There's a thread over on am I being unreasonable about a few posters who have admited they cannot be arsed to finsih the coruse of antibiotics and never have done in their lives. Go and look.

Perhaps this is why GPs stopped handing them out like sweets. People just aren't responsible with them.

hoomach · 29/01/2011 09:17

The issue of antibiotic resistance is real and growing and there are some who feel that in 20 years time we may be back to the dark ages before antibiotics.
There has been injudicious over-use by the medical profession but that pales in comparison to the injudicious use in the veterinary world and the food business (that's how they make things like chickens grow quick and large). There's also been a pattern of inappropriate demand from patients.
The reality is that most minor infections do not need or merit antibiotics.
There's also the specific issue about how "tonsillitis" is treated. As others have said large, red pus-covered tonsils with tender neck glands and high fever probably merits antibiotics. Of course, it may still be viral but it is unrealistic to swab everyone and wait a week for the result to come back from the lab.
But antibiotics for tonsillitis have to be logical. What are we trying to treat? The answer is a bacteria called streptococcus (the same one that in days of old caused scarlet fever and rheumatic fever). If we wish to treat that and eradicate it the best antibiotic (indeed the only really sensible one) is good, old-fashioned penicillin given (for an adult) in the correct adult dose which is 500mg four times a day (and if you really want to eradicate the streptococcus then you may need to take it for up to 10 days). If you are penicillin-allergic then erythromycin will do just fine. But there is less logic for using antibiotics like amoxicillin or cefalexin/cefuroxime or "combination" antibiotics like Augmentin. These will be less effective and also have a higher risk of causing antibiotic-related problems like C. diff infections.

topsi · 30/01/2011 19:13

yes I think an ongoing illness that is not detting better and evidence of systemic infection ie temperature and white spots on tonsills is usually a reason for abx.
i guess if you go back a couple of days later and are no better then you will get presribed some

Keziahhopes · 30/01/2011 22:17

CheeryCola - I was in hospital recently for septic tonsillitis and one thing they gave me which reduced pain loads was Difflam mouthwash, you can buy it at any chemist. I keep it in now, as my recent tonsillitis was viral and still hurt so used the difflam. Comes in a spray as well but the mouthwash actually numbed so well stuck to it.

alypaly · 25/02/2011 22:21

cheery the white dots on your tonsils are not tonsiliths are they.

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