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trouser chili posted:It's now been one month and one day since I first got sick with what appeared to be strep throat. I've completed three rounds of antibiotics, and every time I go on them I get better, but within three days of going off I get sick again. Wednesday I took my last Penicillin V Potassium. Last night my throat was irritated, now my right tonsil is swollen and I feel nauseous and weak again. Also I have kidney pain on the right side again. This is not good and I'm unhappy, and I don't know what to do. I mean I called the doc again, left a message and I'm waiting, but this is strike number three for antibiotics. a) It probably isn't Strep b) Even if it were, it would decrease the duration by less than a day c) The point of antibiotics for Strep throat isn't to treat Strep throat, it's to prevent rheumatic heart disease Hopefully your doctor tested you for Mono.
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Aug 28, 2020 16:58
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| # ¿ May 19, 2024 09:32 |
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trouser chili posted:Thanks for the insight. I was tested for mononucleosis during my last visit to the urgent care center, they ran couple tested including a rapid for strep that was negative. I don't know the results of the other tests other than a pre-recorded phonecall that said the tests were complete and I'm on the right treatment plan (Penicillin V Potassium 500MG two tabs every 12 hours). No problem. Antibiotic overuse for pharyngitis by people who don't understand Centor Criteria, pretest probability impact on test accuracy, and the simple fact that penicillin is not intended to treat the disease, only its sequelae, is a huge pet peeve of mine. You probably need to treat at least 20,000 people to prevent one case of rheumatic heart disease nowadays, and something like 1/9 of patients will have some sort of adverse effect to the antibiotics. Couple that with the fact that 1/8 people's throats are colonized with Group A Strep (and so will always have a positive rapid strep), and you end up with a ton of people on unnecessary antibiotics. There's actually a part of me that's happy that whoever saw you (who was probably an NP or a PA) didn't put you on steroids and a five-day course of azithromycin. That's, like, the undertrained midlevel cocktail for everything ENT.
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Aug 29, 2020 01:14
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STR posted:I had a STD workup done the other day. The q-tip up the p-trap is NOT fun, guys. Urine is great for Gonorrhea and Chlamydia. People only get swabbed when the person ordering the test either doesn't know better or is being vindictive.
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Aug 31, 2020 19:06
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It's basically a joke with nurses. If a guy tells triage that he stepped out and needs to be tested, they ask us to order the swab. (We do not. I only use a swab if there's copious discharge and I want to do a wet prep to look for Trich, and that doesn't necessitate actually sticking the swab up in there.)
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Aug 31, 2020 19:21
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