Insanity is trying the same thing over and over again and expecting a different outcome.
The father and son duo who I have seen three times since Christmas break have returned again. The father is scowling because last time I refused to an order an antibiotic for his son’s allergies. Of course the first visit I had relented because the office was busy and the father practically demanded one. “ There are some fragile older relatives in the house. What I am kinda saying is we need that antibiotic.”
Flash forward a few months later they returned to see me again. The office was not as busy and dad was scowling about his son missing school yet again. The teenager had forgotten to take his allergy medication. This time I educated them about overuse of antibiotics. His father admits his mother has bad allergies. I recommended the teen take his allergy medication regularly and stay hydrated. The father is disgruntled I did not order an antibiotic. He mutters something about the antibiotic not lasting long enough last time.
Two days ago they returned after a few weeks gap. Now teen has a wet cough. He has been taking zyrtec and allegra for his allergies. Teen reports green mucous and worsening over the past few days. Since he has a history of childhood asthma I relent this time to order the antibiotic. The father’s behavior is still very hostile and he scowls throughout the exam declining the strep and flu testing.
Of course I educate on staying hydrated and continuing his allergy regimen. The father asks if his son can play lacrosse. I state that as along as he has no fever and he is breathing fine, he can continue activity as tolerated.
The risk of severe diarrhea resulting in the diagnosis of Clostridioides difficile otherwise know as C. Diff plagues and kills many people across the nation each year. Recently the overuse of antibiotics have led to the discovery of a very resistant fungal infection cause by Candida auris. Medical teams and researchers are finding it difficult to manage the treatment as each regimen fails. A man suffered for ninety days in a New York hospital before succumbing to Candida auris. The unfortunate truth is that suffering could have been prevented had he not become resistant to typical regimens prescribed for his ailments.
I sigh with relief as they leave the clinic sometime later. All I can say sometimes you loose some and sometimes we win. The overuse of antibiotics and pain medications to mask symptoms is a common practice that the patients end up paying the price for sooner or later. As new provider I sometimes find it challenging to educate my patients and their family members regarding the overuse of antibiotics. I attended a conference in New York a few weeks ago regarding gastrointestinal disorders. The common factor reported as the cause was overuse of antibiotics. I may not convince every patient I treat, but I shall make a greater effort to educate them about the possible long term effects about using antibiotics prematurely.
We all need to make a conscious effort to promote probiotic use with antibiotics and perhaps as a routine measure to prevent severe gastrointestinal side effects. The general public still believes the antibiotic is the cure of any ailment they present with. There needs to be more awareness and education in primary care settings , urgent cares and clinics.
Sonali Dhir is a new nurse practitioner. She loves to travel and spend time with her family. She lives in New Jersey