Do I need antibiotics?
Spring is trying to emerge at long last.
Did you need antibiotics this winter? Identifying the odd case that needs antibiotics in a plethora of viral infections is not straightforward without the right equipment.
My garden seems to be telling me that we are emerging from what was a tough winter in many ways. On the medical front we have had a lot of bugs circulating alongside coronavirus, including the Strep throat and Scarlet fever outbreak, and I have had a number of conversations with people who just don't feel that they have been free from infection for any protracted period for months. The challenge for doctors for many years, particularly since the emergence of antibiotic resistance as a concern, has been identifying who needs antibiotics and who does not.
Most people are familiar with the fact that bacteria can be treated with antibiotics, but a virus is a different beast that cannot. What confuses matters is that people will get better from a viral cold anyway (see my earlier article for tips on how!), but if that is taking a little bit of time they may have had a chance to persuade a doctor they need antibiotics, and can then find themselves getting better whilst taking them, but despite them not because of them. Understandably it can then seem unreasonable to be denied them in similar circumstances at a later date. No doctor wants to be argue with their patient, and you would struggle to find a GP who had not prescribed antibiotics against their better judgement to avoid conflict.
For Lisle Medical this has been the first winter flu season with the Quikread Go instrument from Una Health, and it has been a real gamechanger.
Quikread Go is a machine that will process a fingerprick blood sample in a couple of minutes, and it can test a variety of things. Lisle Medical uses it to test for CRP - if your CRP is high it’s probably a bacterial infection needing antibiotics, but if it’s normal or only slightly raised you probably don’t need antibiotics. This quantifiable objective result is at last available at the bedside rather than waiting for a lab to process it in a day or two, and has been a pleasure to work with. At every use I have had my only little internal bet with myself on whether my hunch was correct, and I have had a few surprises this winter. There have been a couple of cases where I would not have recommended antibiotics that in fact did need them; there has been one case where the patient was very averse to the idea of antibiotics but persuaded of their value in the face of a raised CRP; in one case the patient is unable to communicate verbally and therefore such objective evidence becomes even more important; and there have been a couple of cases where I was sure this was going to be a pneumonia, but in fact it was not so much infection causing the symptoms but a flare of pre-existing lung conditions. This has saved some people undue illness, and some people unnecessary antibiotics, and I am pleased that I will be able to offer this to my patients now.
