Author Topic: Over-presciption of antibiotics  (Read 3370 times)

Hope

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Over-presciption of antibiotics
« on: August 19, 2015, 12:24:44 PM »
Yesterday saw yet another attempt to reduce the over-prescribing of antibiotics - http://www.bbc.co.uk/news/health-33961241

Since so many doctors report that they are being hassled by patients into prescribing them unnecessarily, would an answer be to develop a very simple pill that can be prescribed to give those patients a sense of well-being, even if the pill only contains a very small dose of Vitamin C or some other useful, and harmless dietary chemical?  Of course, they would also have to have some of ingredient that mimics the nasty side-effects of some antibiotics.   ;)
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Harrowby Hall

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Re: Over-presciption of antibiotics
« Reply #1 on: August 19, 2015, 01:26:40 PM »
And when did you last receive a prescribed drug that did not come in a package containing details of the constituents of that drug and a leaflet providing considerable information about the use, side effects and possible ill-effects of that drug?

Are you suggesting that placebos (nothing wrong with placebos) be prescribed with either no supporting information? Bit of a giveaway, that. Or containing information that is fictition and fantasy? What does that say about the doctor-patient relationship?

I think the days when patients were so ill-informed that a bottle bearing the legend "The Mixture" was considered acceptable. Five minutes trawling the internet would lead to making contact with the GMC or some shady lawyer practising in damage claims.

I think that doctors have just got to brace themselves and tell patients the facts.
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Udayana

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Re: Over-presciption of antibiotics
« Reply #2 on: August 19, 2015, 01:29:20 PM »
A placebo? But then what happens when someone presenting with what appears to be a cold turns out to have some nasty bacterial infection? What happens when patients find out they have been misled and stop trusting their doctors?

To an extent the problem must be due to not being able to diagnose problems at an early stage eg. without pathology or monitoring.
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floo

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Re: Over-presciption of antibiotics
« Reply #3 on: August 19, 2015, 01:30:00 PM »
There should certainly be a crackdown on the over-prescription of antibiotics if we don't want a world where they cease to be effective.

Hope

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Re: Over-presciption of antibiotics
« Reply #4 on: August 19, 2015, 01:33:58 PM »
And when did you last receive a prescribed drug that did not come in a package containing details of the constituents of that drug and a leaflet providing considerable information about the use, side effects and possible ill-effects of that drug?
How many patients actuyally have any idea of what the ingredients listed mean or do?

Now, I'm not suggesting that we condone fraud, but might not a perfectly correctly labelled and leafleted tablet that contains no anti-biotic be developed.
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Udayana

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Re: Over-presciption of antibiotics
« Reply #5 on: August 19, 2015, 01:36:47 PM »
Is there a link to a recent study that shows that there is over-prescription?
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Hope

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Re: Over-presciption of antibiotics
« Reply #6 on: August 19, 2015, 01:38:02 PM »
What happens when patients find out they have been misled and stop trusting their doctors?
Isn't their insistence that they be given an antibiotic indicative of their already having lost trust in their doctor?

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To an extent the problem must be due to not being able to diagnose problems at an early stage eg. without pathology or monitoring.
Not to mention the fact that so many 'ordinary Jo's' seem to think that antibiotics are the magic bullet for all illnesses.
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Hope

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Re: Over-presciption of antibiotics
« Reply #7 on: August 19, 2015, 01:41:38 PM »
Is there a link to a recent study that shows that there is over-prescription?
Over the years there have been multitudinous such reports and papers

Try some of these - http://tinyurl.com/pfomxcf

From the article linked to in the OP:
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There is universal consensus that the very basis of modern medicine is under threat due to rising numbers of infections that are resistant to drugs.

The "antibiotic apocalypse" not only means that long-forgotten infections could kill again, but jeopardises procedures including surgery and chemotherapy.

Using antibiotics inappropriately for sore throats and colds increases the risk of resistance. Yet the number of prescriptions continues to rise.
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Shaker

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Re: Over-presciption of antibiotics
« Reply #8 on: August 19, 2015, 01:42:31 PM »
Isn't their insistence that they be given an antibiotic indicative of their already having lost trust in their doctor?
Not really. More often it's indicative of medical ignorance - "Oh my God, I've got a rotten cold. I'd better get some antibiotics."
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Hope

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Re: Over-presciption of antibiotics
« Reply #9 on: August 19, 2015, 01:46:22 PM »
Not really. More often it's indicative of medical ignorance - "Oh my God, I've got a rotten cold. I'd better get some antibiotics."
Yet the insistence is often over and against their doctor's statement at the time that they don't need antibiotics.
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floo

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Re: Over-presciption of antibiotics
« Reply #10 on: August 19, 2015, 01:49:31 PM »
I dislike any form of medication and always question whether it is really necessary if the doctor prescribes it for me. I will do so even more now, as the statins I was prescribed for very high cholesterol levels did more harm than good where my liver is concerned! :o

Shaker

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Re: Over-presciption of antibiotics
« Reply #11 on: August 19, 2015, 01:50:43 PM »
Not really. More often it's indicative of medical ignorance - "Oh my God, I've got a rotten cold. I'd better get some antibiotics."
Yet the insistence is often over and against their doctor's statement at the time that they don't need antibiotics.
That's right - that's the ignorance I was referring to.

It's not lost trust - quite the opposite, it's trusting that the doctor will give them something that they (wrongly) believe will work.
 
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Udayana

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Re: Over-presciption of antibiotics
« Reply #12 on: August 19, 2015, 01:51:44 PM »
I dislike any form of medication and always question whether it is really necessary if the doctor prescribes it for me. I will do so even more now, as the statins I was prescribed for very high cholesterol levels did more harm than good where my liver is concerned! :o
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ekim

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Re: Over-presciption of antibiotics
« Reply #13 on: August 19, 2015, 02:01:36 PM »
And when did you last receive a prescribed drug that did not come in a package containing details of the constituents of that drug and a leaflet providing considerable information about the use, side effects and possible ill-effects of that drug?
How many patients actuyally have any idea of what the ingredients listed mean or do?

Now, I'm not suggesting that we condone fraud, but might not a perfectly correctly labelled and leafleted tablet that contains no anti-biotic be developed.
Isn't that called homeopathy?

Udayana

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Re: Over-presciption of antibiotics
« Reply #14 on: August 19, 2015, 03:27:27 PM »
"proscribing antibiotics just in case" Proscribing or prescribing? Prescribing "just in case" is probably causing the problems with resistant strains.
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Hope

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Re: Over-presciption of antibiotics
« Reply #15 on: August 19, 2015, 03:38:19 PM »
What about the doctors duty of care? And what happens when his patient dies because he has made a mistake.
Don't doctors have a duty of care to everyone, not just their own patients? 

Quote
Doctors don't always get it right, and it's a bit much to expect them to choose who to deceive and live by the consequences.
Yet, it could be argued that this is precisely what they are doing, Rose.  They are potentially deceiving their patients into thinking that their virally-related condition will be healed by a bacteria-specific drug.

Quote
I know what I would like to see, more diagnostic tests, instead of guesswork and proscribing antibiotics just in case.
The problem seems to be, at least in part, that the patients don't believe the test results and insist on antibiotics as the magic bullet.

I am not suggesting that doctors prescribe such a placebo willy-nilly; just when they are certain that antibiotics won't deal with the issue, but patients insist that it will.
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