Quote:
Originally Posted by Chrysalis
Thats why I said just one pack of antibiotics per year enough for a 5 day run.
Whilst it may be easy to say they over subscribed its worth bearing in mind some people really over estimate the ability of the immune system to fight infections, before antibiotics were invented people died at a much younger age from minor ailments that could get out of control. So something that starts of as trivial without treatment can become serious. This risk that you talk about can be mitigated by only supplying one type of antibiotics this way, e.g. so most of the antibiotics remain prescription only.
I have never been refused antibiotics whenever I have suggested it either to a dentist or GP, so the system as far as I am concerned has never blocked the use of antibiotics but only delayed it.
This is of course without taking into consideration like people been absent from work etc. whilst waiting to see a doctor.
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It is slightly dangerous to think of antibiotics as this panacea that can be taken with no risk to the individual or long term consequences to the population as a whole.
Whilst I would be one of the first to acknowledge their benefit to overall life expectancy as well as their ability to cure diseases that at one time were a death sentence. It is also important to acknowledge that they have to an extent been abused and dished out like smarties by doctors for a variety of reasons and we are now left with a situation where resistant bugs are becoming more and more common! MRSA, VRSA, carbapenemase producing enterococci to name a few of the top of my head.
Sad fact is that most antibiotics that have been prescribed were not needed and have simply been used to treat viral infections or mild bacterial infections that the bodies own immune system would have dealt with if it had been given a chance. These infections are largely self limiting and whilst they can be unpleasant they are not in themselves any threat to the individual. In fact there is increasing evidence that show a correlation between increasing antibiotic use and increased incidence and prevalence of autoimmune disease.
Your idea of only making one antibiotic available to prevent resistance is unrealistic as it assumes that any antibiotic can be used to treat any type of bacterial infection and this quite simply is not true. Most antibiotic regimens are tailored to the likely bug that is causing the infection for example trimethoprim and nitrofurantoin tend to work well on bacteria that cause UTIs whereas amoxicillin and clarithromycin tend to work well on bugs that cause chest infections, and for dental infections metronidazole tends to be the antibiotic of choice. That's not to say there aren't antibiotics that have a very broad spectrum and can be used against multiple types of infections, the problem with these though is they tend to need to be given intravenously such as tazocin or ertapenem and often have very nasty side effects such as in some cases liver failure.
All that said there are advantages to making antibiotics available to certain groups of high risk patients where the benefit of ensuring they receive prompt antibiotic therapy outweighs the risk, for example patients with COPD will often get a "rescue pack" from their GP which contains steroids and an antibiotic usely doxycycline. When these patients get the start of an infection they can start their rescue pack medication and then book to see a GP.
It's difficult for me to comment as to why you have always been given antibiotics when you have suggested it to the GP or dentist without knowing the circumstances around it. My slight worry though is that as you had to suggest it, they may not actually have been needed but this may have simply been a way to get you out of the door quicker! It's a sad fact that GPs are heavily constrained by time with 10 minutes for a consultation at a good practice and some have just 5 at poorer practices. Faced with a patient who questions whether they should have antibiotics the GP may have to weigh up the time taken to explain the rationale of not giving antibiotics which can take 1-2 minutes if the patient is understanding or much longer if the patient wants to argue! Compared to the 10 seconds it takes to print of a prescription. In this circumstance especially if the GP is already over running they may simply be taking the path of least resistance.