It seems you need to continually reassure doctors and patients that this the most evidence based protocol . Its like CPR training -skills wane with time repeating is needed yearly -Some patients are angry if they do not get the maximum possible for distressed children . The belief in antibiotics is strong in otitis media -with fever and crying -and most doctors will give them when they cannot see the tympanic membrane because of wax . In patients over 55 it is nerve racking not to give antibiotics if there is a persistent cough with a fever particularly in smokers and it gets more troubling with age of the patient such that over 65 many would give amoxycillin or azithromycin for a established acute bronchitis .
I agree - it bears repeating and repeating - I understand the tension between wanting to be a good 'steward' but also wanting to provide maximum individual patient benefit by prescribing antibiotics when someone has fever and cough even when you think it is almost surely viral - That's why I love the wait and see or delayed approach as I feel it is the best way to resolve that tension. mm
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Ian L. - June 15, 2021 9:29 PM
It seems you need to continually reassure doctors and patients that this the most evidence based protocol . Its like CPR training -skills wane with time repeating is needed yearly -Some patients are angry if they do not get the maximum possible for distressed children . The belief in antibiotics is strong in otitis media -with fever and crying -and most doctors will give them when they cannot see the tympanic membrane because of wax . In patients over 55 it is nerve racking not to give antibiotics if there is a persistent cough with a fever particularly in smokers and it gets more troubling with age of the patient such that over 65 many would give amoxycillin or azithromycin for a established acute bronchitis .
Mike M. - June 16, 2021 9:03 AM
I agree - it bears repeating and repeating - I understand the tension between wanting to be a good 'steward' but also wanting to provide maximum individual patient benefit by prescribing antibiotics when someone has fever and cough even when you think it is almost surely viral - That's why I love the wait and see or delayed approach as I feel it is the best way to resolve that tension. mm