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by ceejayoz 60 days ago
A similar thing happens in the US; people demand antibiotics for a cold. It’s easier to say yes than to explain the reason it won’t work.
6 comments

Antibiotic overprescribing was a problem in the past, but in my experience providers around me are very resistant to giving antibiotics at all.

My doctor’s office even has a big sign in the waiting room saying they don’t prescribe antibiotics for common infections.

The last time I got strep throat the urgent care clinic was resistant to testing me but finally gave in. When it came back positive the doctor acted oddly like he was reluctantly willing to prescribe antibiotics for it.

My dad in India gets prescribed antibiotics whenever he's sick. Despite my constant explanations, he insists that this is how it should be, because when you're sick your immunity is lowered.

On the other hand, the last time I got prescribed antibiotics was probably almost 10 years ago when I ended up in the hospital from an abscess.

Granted, my dad is old, but that part of the world still seems to expect doctors to do more for a common cold than just tell you to rest for a week and take an acetaminophen or phenylephrine if/when needed (even when that's really all you need).

> Granted, my dad is old, but that part of the world still seems to expect doctors to do more for a common cold than just tell you to rest for a week and take an acetaminophen or phenylephrine if/when needed (even when that's really all you need).

FYI phenylephrine is effectively a placebo and the FDA has proposed ending its use in OTC drugs. (There've been HN threads on the subject, with many comments.)

Pseudoephedrine works great though.

Phenylephrine is a placebo for nasal congestion, but it’s a solid drug for raising blood pressure. Used all the time in anesthesia (obviously not an OTC use).
> The last time I got strep throat the urgent care clinic was resistant to testing me but finally gave in. When it came back positive the doctor acted oddly like he was reluctantly willing to prescribe antibiotics for it.

For strep in particular, wiki indicates that not treating with antibiotics isn't unreasonable (presumably opinions will vary by doctor): https://en.wikipedia.org/wiki/Streptococcal_pharyngitis#Anti...

I don’t know how widespread it is, but some people will beg for antibiotics when they definitely have a viral infection.

My friend who always used a naturopath would go on endlessly trying to diagnose herself with viral or bacterial to decide whether she should ask for antibiotics, but I definitely got the point.

I suppose many patients simply don’t know the difference.

I know antibiotics are really popular because killing bacteria seems really effective, but have you considered asking your doctor for a probiotic treatment?

Oral probiotics tend to work really well (similar effect to getting rid of bad bacteria) because they don't have to survive the stomach acid.

Why do you say oddly? Prescribing antibiotics just because is how you get resistance.
Prescribing antibiotics for contagious bacterial infections is their exact usage.

Some doctors argue against using antibiotics for strep, but it's definitely debatable.

Is that true or just a rumor? All the family medicine people I know would not do that. Only in a case where it is 50/50 bacterial or viral like an ear infection in a young kid.
There is more effort today to avoid overprescribing antibiotics, but in cases where diagnosis is not certain, most providers will oblige
In the UK, nothing is ever bacterial lol

I had a horrible tooth infection that anyone with a nose could tell was a bacterial infection yet I was massively gaslit and denied antibiotics until I went to the hospital at 11pm after a week of horrendous pain

Doctors very rarely do any kind of test in my experience (I would have thought oozing stinking green stuff would have been easy to test...)

Later

I am somewhat against antibiotics as I have a fragile/already destroyed gut. But there are times when I don't know what other solution there is after exhausting home remedies, other medication and waiting it out

A friend passed away few months ago in London from kidney infection.

UK seems very to be very cautious of over diagnosis, while my experience in Eastern Europe was opposite - my infant received 3 different kinds of steroids (potentially what stunned his growth).

I'm very sorry to read that

IMO there is a huge amount of denial of treatment to save costs. The gaslighting over symptoms, the refusal to refer you to specialist, the refusal to order tests etc is all part of it. And they never ever say it's about costs - just a tight lipped, "I know what's best" attitude

> A similar thing happens in the US; people demand antibiotics for a cold. It’s easier to say yes than to explain the reason it won’t work.

Are there placebos that could be given instead?

More than that, it's often easier to just prescribe something than to figure out if it is bacterial or viral.
Could just prescribe sugar pills then instead of antibiotics for a cold.
IME, most people (in the US) don't bother going to a doctor for a cold unless it lasts a long time or is especially bad, because you'll probably get better on your own and going to the doctor is expensive.
I was working in a church office when I came down with a runny nose and other cold symptoms.

My supervisor told me I could stay home for a day, but if longer than that, I would require a doctor’s excuse.

Now, that seemed fair from a labor perspective, but it is extremely unfair to someone like me. Because I do not own a vehicle, and seeing a doctor would involve boarding one or more buses and snorking the entire way there and back. Risking infection for everyone around me was exactly what I sought to avoid by staying home.

So what else could I do, but come into work and carry on? It is this sort of unreasonable requirement that fuels “presenteeism”.

> My supervisor told me I could stay home for a day, but if longer than that, I would require a doctor’s excuse.

You'd think the supervisor would realize it's in their own self-interest for you to not be around spreading infection (to them) by your mere presence.

There are of course people who abuse systems where doctors notes are not needed, and call in and then go have fun. It's not too hard to come across stories of people getting on short/long-term disability by know the correct doctor (I know of a situation where 3 members of the same family went to the same doctor and got a note for some condition).

I see this as a dereliction of duty by doctors' associations; they should all have standing policies forbidding the provision of sick notes.
We don't give these hypochondriacs saline injections with dirty needles, though.