Why did the doctor not prescribe antibiotics?

Why doctor did not prescribe antibiotics?

Is there an antibiotic in the prescription?

Can you call the doctor to add antibiotics to the prescription?

These are the few questions I get daily, from my patients.

Antibiotics were a big deal when they were first discovered in the mid-20th century. Initially hailed as a revolutionary medical advancement, antibiotics saved countless lives by effectively treating bacterial infections.

However, the overreliance and misuse of antibiotics have diminished their effectiveness over time.

The misuse of antibiotics is a prevalent issue that pharmacists play a vital role in addressing.

CDC estimates that at least 30% of antibiotics prescribed in the outpatient setting are unnecessary, meaning that no antibiotic was needed at all. Total inappropriate antibiotic use, inclusive of unnecessary use and inappropriate selection, dosing, and duration, may approach 50% of all outpatient antibiotic use.

Some High-priority conditions are conditions for which clinicians commonly deviate from best practices for antibiotic prescribing and include conditions for which antibiotics are overprescribed, underprescribed, or misprescribed with the wrong antibiotic agent, dose, or duration.

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Examples of types of high-priority conditions

• conditions for which antibiotics are overprescribed, such as conditions for which antibiotics are not indicated (e.g., acute bronchitis, nonspecific upper respiratory infection, or viral pharyngitis).
• conditions for which antibiotics might be appropriate but are overdiagnosed, such as a condition that is diagnosed without fulfilling the diagnostic criteria (e.g., diagnosing streptococcal pharyngitis and prescribing antibiotics without testing for group A Streptococcus).
• conditions for which antibiotics might be indicated but for which the wrong agent, dose, or duration often is selected, such as selecting an antibiotic that is not recommended (e.g., selecting azithromycin rather than amoxicillin or amoxicillin/clavulanate for acute uncomplicated bacterial sinusitis).
• conditions for which watchful waiting or delayed prescribing is appropriate but underused (e.g., acute otitis media or acute uncomplicated sinusitis).
• conditions for which antibiotics are underused or the need for timely antibiotics is not recognized (e.g., missed diagnoses of sexually transmitted diseases or severe bacterial infections such as sepsis).https://www.cdc.gov/antibiotic-use/core-elements/outpatient.html

Why antibiotics are inappropriately prescribed?

Inappropriately prescribed antibiotics are a significant concern and can occur for various reasons.

Here are some common ways in which antibiotics may be prescribed inappropriately:

Viral Infections

Antibiotics are designed to combat bacterial infections, not viral infections like the common cold or the flu. However, due to patient expectations or a lack of definitive diagnostic tests, healthcare providers may sometimes prescribe antibiotics unnecessarily for viral illnesses.

Pressure from Patients

Patients may request antibiotics for conditions that don't warrant their use, influenced by a desire for a quick remedy or a misunderstanding of the nature of their illness. In response to patient pressure, healthcare providers might prescribe antibiotics even when not medically necessary.

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Diagnostic Uncertainty

In some cases, healthcare providers may face challenges in accurately diagnosing the cause of an infection. Faced with uncertainty, they may choose to prescribe antibiotics as a precautionary measure, contributing to overuse.

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Incomplete Evaluation

Inadequate patient assessments or failure to obtain a comprehensive medical history can lead to antibiotic prescriptions without a clear understanding of the root cause of the symptoms.

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Prophylactic Use

Antibiotics are sometimes prescribed prophylactically to prevent infections before certain medical procedures. While this is appropriate in many cases, overuse or unnecessary prophylaxis can contribute to antibiotic resistance.

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Patient Expectations

Some healthcare providers may prescribe antibiotics to meet patient expectations, even when there is uncertainty about the bacterial nature of the infection. This can occur due to time constraints during medical appointments or concerns about patient satisfaction.

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Lack of Awareness

In some cases, healthcare providers may not be fully aware of the current guidelines for antibiotic use or may not stay updated on the latest information regarding antibiotic resistance.

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Self-Prescribing

In certain situations, individuals may obtain antibiotics without a prescription or share them with others, leading to inappropriate use and contributing to antibiotic resistance.

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Pharmacists, as healthcare professionals, play a pivotal role in educating patients about the appropriate use of antibiotics.

They can explain to patients that antibiotics are not indicated for viral infections, emphasize the importance of completing prescribed antibiotic courses to prevent resistance, and discourage the sharing of antibiotics or self-medication.

By offering clear and concise explanations, pharmacists contribute to the responsible use of antibiotics, helping to preserve their efficacy for genuine bacterial infections.

This patient education is essential in preventing unnecessary antibiotic prescriptions, reducing the risk of antibiotic resistance, and promoting overall public health.

Remember tiny changes make a big impact.

As a white coat owner, how can you help to resolve this problem?

Comment below and share your thoughts and experiences!

Stay Tuned

Love, Fathima