“I’m Sick, I Want An Antibiotic!”

November 27, 2011

Health Promotion

 

"Mommy, I'm sick"

I see many patients that come to see the nurse practitioner hoping for an antibiotic for their symptoms of cough, runny nose, headache & generalized weakness that has been going on for 2 days.  The examination is basically negative; in other words, there isn’t a specific cause for the symptoms.  If the person smokes I can usually diagnose with acute bronchitis; however, if the patient does not have any other health problems acute bronchitis can be self –limiting; meaning, that the infection will go away on its own without antibiotic treatment.  However, these patients are usually expecting an antibiotic even though the signs of a bacterial infection are not clear. After all, these patients came to the office and will be paying for the visit, how could I not prescribe an antibiotic? Would you be upset with the practitioner if they told you to continue to rest at home, drink plenty of fluids, take OTC cough and fever reducing remedies and return to the office if symptoms persist after 10-14 days because that’s how long some viral infections last? Of course there are exceptions to this rule like people with health problems including diabetes, COPD or other lung problems and patients that are immuno-compromised. These patients should see as soon as symptoms appear.  A bacterial infection may be the result of a “secondary infection” (meaning that the virus initiated the process but a bacteria followed). You should see your health care provider if:

•             Your symptoms persist longer than the expected 10-14 days a virus tends to last

•             Your fever is higher than one might typically expect from a virus (100.5 F).

•             Your fever gets worse a few days into the illness rather than improving

Beware, there are health care providers that will tell you to give it some time and send you home with advice that you’ve already gotten for free.  So, if you are generally healthy and are feeling bad with what could be a viral infection, stay at home and give it a tincture of time before coming to the practitioner for an antibiotic.

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