WHY WON’T GPS PRESCRIBE ANTIBIOTICS?
My Weekly’s favourite GP Dr Sarah Jarvis from TV and radio writes for you
The first antibiotic, penicillin, was identified by Dr Alexander Fleming almost a century ago, in 1928. Since then, antibiotics have saved countless lives.
Before then, the commonest cause of death among under 50s and among the most common for all under 75s was infection. Of course,, vaccines have helped prevent infectious diseases as well but antibiotics have been key. Unfortunately, more and more bacterial infections are becoming resistant to antibiotic treatment. We can all do our bit to reduce this risk.
The Covid-19 pandemic has reminded all of us of the threat of infection, especially when we w don’t have effective tr reatments. Of course, Covid-19 C is caused by a vi irus: there are some tr reatments that work against a viruses, but antibiotics a have no effect. e
A host of other i nfections are caused by b bacteria, and that’s where antibiotics come in. Serious infections like pneumonia or bacterial meningitis are often deadly without treatment. Other bacterial infections don’t cause problems for most people, but can spread deeper into the body, causing severe illness. Others still, such as cystitis, can be very distressing.
Different bacteria are vulnerable to different antibiotics. For instance, standard treatment for severe tonsillitis is penicillin V, because it’s usually caused by a germ called strep.
E coli, on the other hand, is responsible for many cases of cystitis. Penicillin V is powerless against E coli, but nitrofurantoin will often work.
Penicillin V and nitrofurantoin are called “narrow-spectrum” antibiotics, because they only treat a small range of germs. When they work, they’re extremely effective, but there’s a greater chance they will come up against a resistant germ. “Broad-spectrum” antibiotics succeed against a wider range of germs, but carry a higher risk of causing antibiotic resistance.
GPs have been working under ever-increasing pressure in recent years. New research shows that pressure could lead GPs to prescribe more broad-spectrum antibiotics. That’s because patients often don’t want to wait for the results of tests to check what antibiotic would be suitable. Between 2010 and 2017, the number of GPs who said they had experienced high demand from patients increased from under 2 in 3 to almost 9 in 10.
Lots of infections are caused
‘‘ OVER 65 AND NOT VACCINATED AGAINST PNEUMOCOCCAL INFECTION? SPEAK TO YOUR ’’ PRACTICE NURSE – IT’S A SINGLE DOSE
by viruses – and antibiotics are completely useless against them. Even worse, while they won’t do any good, giving antibiotics for virus infections does increase the risk of more antibiotic-resistant bacteria.
In many other infections caused by bacteria, your body has a good chance of fighting them off without antibiotics. You’ll recover if you take them – and just as fast if you don’t.
Every time you take an antibiotic, it’s more likely the next infection you get will be harder to treat because it’s resistant to antibiotics. So taking them when you don’t need them can be harmful.
We’re not talking here about very serious infections like meningitis, pneumonia, kidney infections or blood poisoning. For these, antibiotics are essential. That’s why we all need to do our bit to keep antibiotic resistance down and keep antibiotics working.
Good examples include ear or minor skin infections (like boils), sore throats, tickly coughs and sometimes cystitis. Your doctor can’t always tell by examining you if you have a bacterial infection. However, they will know if it’s more likely than not to be a virus – and if you have an infection which will likely clear up just as quickly without treatment.
In this case, they’ll recommend that antibiotics aren’t necessary. However, they will also stress that if your symptoms worsen, or you develop new symptoms, you should come back. In some cases, they’ll give you a “delayed prescription” for antibiotics, to take if symptoms don’t improve in a few days.
If you think you need antibiotics but your doctor doesn’t offer them, ask why – they’ll be able to explain.
NEXT WEEK: The Waiting Game