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Posted on 9/3/19 at 4:24 pm to Chucktown_Badger
quote:
And yes, part of the superbug issue is overuse of antibiotics. The bigger issue is that people stop taking them when they start to feel better instead of finishing the full course.
So if you ever get prescribed antibiotics, TAKE ALL OF THEM.
This
Posted on 9/3/19 at 4:28 pm to Bedhog
quote:
Antibiotics for strep without even running a test. Only visual inspection of ears and throat.
Isn't it frowned upon by civility standards because of the fear that viruses may gain immunity to antibiotics to just go around throwing antibiotics prescriptions?
I actually told the doctor this and she seemed to take offence and basically made me feel bad for questioning this.
Strep can be dangerous. I wouldn't screw around with it.
Posted on 9/3/19 at 4:32 pm to Bedhog
quote:
again. Even if its identified, what good will antibiotics do against a VIRUS?
In the event that it was viral. Nothing, you let it run it’s course if it’s a virus
But based on the clinical presentation and symptoms usually providers will be able to tell.
This post was edited on 9/3/19 at 4:33 pm
Posted on 9/3/19 at 4:33 pm to moneyg
She may have been using the Centor Criteria to diagnose. If you have 5 points you can technically just prescribe antibiotics without the test depending on scenario. However, it is still recommended to consider performing the test/culture. She may also have been prescribing antibiotics not for strep but for a middle ear infection she may have seen on exam.
Posted on 9/3/19 at 4:35 pm to Tigerbait357
I just left an after hours clinic and I tested positive for strep. It sucks, a lot.
Wife has been sick since Saturday, but tested negative for strep or flu. Hasn’t stopped her from being the miserable frick that she always is when she doesn’t feel well.
Wife has been sick since Saturday, but tested negative for strep or flu. Hasn’t stopped her from being the miserable frick that she always is when she doesn’t feel well.
This post was edited on 9/3/19 at 4:42 pm
Posted on 9/3/19 at 4:41 pm to Bedhog
Had the opposite occur. NP insisted my kid was too young for strep. Would not do the strep test and assured us it was viral. After several days of no change, we brought kid back and an actual doctor looked at it, did strep test and lo and behold, it was strep.
Antiobiotics gave him relief within one day. Poor kid could have been feelin better for days.
Needless to say, Ms. Tigahbruh will get pissy with them from now on if the only one available is the NP.
Antiobiotics gave him relief within one day. Poor kid could have been feelin better for days.
Needless to say, Ms. Tigahbruh will get pissy with them from now on if the only one available is the NP.
Posted on 9/3/19 at 4:45 pm to pussywillows
Look. I made the mistake of calling Strep a virus. I meant bacteria. I did not and will not edit my OP because I just dont do that. I will eat my crow for that slip up but everyone else knows it is a bacteria that can be treated with antibiotics. I would just prefer a doctor to do a culture to verify.
Posted on 9/3/19 at 4:48 pm to Bedhog
Guy I work with didn’t take the antibiotics for strep and ended up in the hospital with sepsis. Strep is nasty.
Posted on 9/3/19 at 4:52 pm to Bedhog
quote:
viruses may gain immunity to antibiotics
Damn, son.
1. Strep is a bacterial infection.
2. Antibiotics don’t work on viruses.
3. The main problem with antibiotics besides being over prescribed for piss ant infections is that people don’t finish taking the pills. They stop once they feel better. That means any surviving pathogens have been exposed to the antibiotic but didn’t die are more likely to pass on resistance to that antibiotic genetically.
Posted on 9/3/19 at 5:01 pm to Bedhog
quote:Are you a Dr?
I actually told the doctor this and she seemed to take offence and basically made me feel bad for questioning this.
You dont need to go to the Dr's office to play Dr.
Posted on 9/3/19 at 5:05 pm to Bedhog
Yes and no. Sometimes strep is obvious by symptoms and looking in throat.. Some are carriers. You can actually smell strep. Sure a confirmatory test is nice, but not always done.
Strep is not to be played with. I had a coworker die after her second kidney transplant. Her kidneys were destroyed by a strep throat.
Strep is not to be played with. I had a coworker die after her second kidney transplant. Her kidneys were destroyed by a strep throat.
This post was edited on 9/3/19 at 5:10 pm
Posted on 9/3/19 at 5:11 pm to Bedhog
Strep can be pretty serious, so I think the doc is reasonable here. If your child simply had a case of the sniffles, then no I would just tell him to wait it out
(Not a doctor by the way).
(Not a doctor by the way).
Posted on 9/3/19 at 5:13 pm to Bedhog
You don't need a culture to verify strep throat.
It's diagnosable clinically.
It's diagnosable clinically.
Posted on 9/3/19 at 5:16 pm to Bedhog
quote:
Good. I get it. I'm not a doctor yet here we sit in the doctors office with a doctor that was at first willing to prescribe them for a possible viral infection.
Would you question the doctor?
If you are claiming it's a possible viral infection, you are already questioning the doctor.
Posted on 9/3/19 at 5:18 pm to Bedhog
There are lots of things being thrown around in this thread with some at least partially right and a lot wrong with regard to Group A streptococcal (GAS) pharyngitis (colloquially called "strep throat"). As mentioned above, it is a bacterial infection, not a viral infection, and current treatment guidelines (both pediatric and adult) mostly stem from the Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America.
Long story short, patients with signs/symptoms consistent with strep pharyngitis should undergo testing prior to initiation of antibiotics.
For those without access:
Someone mentioned a high Centor score as justification for empiric treatment, but the current treatment guidelines use the Centor score to avoid unnecessary testing in patients with a low probability of having GAS pharyngitis rather than justify antibiotic therapy without testing.
Additionally, you had stated the provider looked in your child's ears. The diagnosis of acute otitis media (colloquially an "ear infection") IS a clinical diagnosis (requires no testing) and current practice patterns and treatment guidelines support antibiotic therapy for these patients. Easiest way at this point to figure out what your provider was treating is to look a the antibiotic/dosing given. If she prescribed high dose amoxicillin (45mg/kg twice a day) then she was probably treating acute otitis media. If she gave penicillin or standard dose amoxicillin (25mg/kg twice a day) she was probably treating GAS pharyngitis.
Long story short, patients with signs/symptoms consistent with strep pharyngitis should undergo testing prior to initiation of antibiotics.
For those without access:
quote:
I. How Should the Diagnosis of GAS Pharyngitis Be Established?
Recommendations 1. Swabbing the throat and testing for GAS pharyngitis by rapid antigen detection test (RADT) and/or culture should be performed because the clinical features alone do not reliably discriminate between GAS and viral pharyngitis except when overt viral features like rhinorrhea, cough, oral ulcers, and/or hoarseness are present. In children and adolescents, negative RADT tests should be backed up by a throat culture (strong, high). Positive RADTs do not necessitate a back-up culture because they are highly specific...
Who Should Undergo Testing for GAS Pharyngitis?
Recommendations 4. Testing for GAS pharyngitis usually is not recommended for children or adults with acute pharyngitis with clinical and epidemiological features that strongly suggest a viral etiology (eg, cough, rhinorrhea, hoarseness, and oral ulcers; strong, high).
Someone mentioned a high Centor score as justification for empiric treatment, but the current treatment guidelines use the Centor score to avoid unnecessary testing in patients with a low probability of having GAS pharyngitis rather than justify antibiotic therapy without testing.
Additionally, you had stated the provider looked in your child's ears. The diagnosis of acute otitis media (colloquially an "ear infection") IS a clinical diagnosis (requires no testing) and current practice patterns and treatment guidelines support antibiotic therapy for these patients. Easiest way at this point to figure out what your provider was treating is to look a the antibiotic/dosing given. If she prescribed high dose amoxicillin (45mg/kg twice a day) then she was probably treating acute otitis media. If she gave penicillin or standard dose amoxicillin (25mg/kg twice a day) she was probably treating GAS pharyngitis.
Posted on 9/3/19 at 5:25 pm to studentforlife
Checked ears. Had fluid behind ear wax.
Cleaned out ears with stool softener, irrigated 5 minutes afterwards.
Called in a script for low dose Amoxicillin, Symbacort and Promethazine syrup.
Cleaned out ears with stool softener, irrigated 5 minutes afterwards.
Called in a script for low dose Amoxicillin, Symbacort and Promethazine syrup.
This post was edited on 9/3/19 at 5:31 pm
Posted on 9/3/19 at 5:27 pm to moneyg
quote:
Strep can be dangerous. I wouldn't screw around with it.
Exactly. It can eff up a heart valve. The OP knows just enough to be dangerous.
Posted on 9/3/19 at 5:31 pm to Poker_hog
quote:WTF? I was just questioning the administration of antibiotics without a culture.
OP knows just enough to be dangerous.
Posted on 9/3/19 at 5:45 pm to atrain5
quote:Strep vax? Where do we get that?
We get it, you dont vax your child
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