Antibiotics info: flucloxacillin amoxicillin
Discussion
I was doing a triathlon over the weekend managed to injure myself. In transition from swimming in the Thames (nice) I did my left bike shoe up too tight and managed to wear the skin off just behind my little toe and broke the heel end of my 5th metatarsal.
After visiting minor injuries and getting assessed and x-rayed I ended up seeing an orthopedic doctor in hospital. I was prescribed both flucloxacillin and (I think, not 100% sure) amoxicillin. When I went to the pharmacy to collect the prescription they had deleted the amoxicillin and only given me the flucloxacillin. I asked why this was and they said because it does the same job so you don't need both. I asked why the doctor would have prescribed both and she said she didn't know but that she had checked with a consultant and that this was fine. They couldn't contact the doctor who had seen me. I went back to A&E to try to find her but after a lot of running around (on crutches) it turned out she was getting ready for surgery. Fair enough.
My problem is that nobody gave me a good reason as to why the doctor had prescribed both when apparantly everyone knows they do the same thing. Then it turned out that it wasn't hospital policy to prescribe both and that the doctor I had seen was a locum.
It may well be that what I have is fine and had I seen a doctor who only prescribed the one drug I'd be none the wiser. The trouble is whenever anyone was querying what I was asking they were never asking the right questions. For example a nurse phoned someone asked "Is flucloxacillin right for treating skin infections?". The answer was yes so of course in the eyes of the nurse the adjusted prescription was right. Is this the case if you've been swimming with all the stuff floating about in the Thames? Is this right if there is a broken bone nearby? I don't know because that question was never asked. Despite numerous polite and reasoned questions it got to the point after an hour where it was clear they would have said anything to get rid of me. It ended up where they said that either you can wait for the doctor I saw to finish surgery (with no estimated timeframe whatsoever, could have be 30 minutes or 10 hours) or you can take the adjusted prescription.
Now I'm sure that what I have will be fine but when the reasons for the change start with "Perhaps she meant...", "Maybe she thought..." and "What she probably meant was..." rather than "This is wrong because of x, y and z" it doesn't leave me with much confidence in the decision.
Seeing as I quite like my foot I was just after some reassurance really. Sorry for the ramble and thanks in advance!
After visiting minor injuries and getting assessed and x-rayed I ended up seeing an orthopedic doctor in hospital. I was prescribed both flucloxacillin and (I think, not 100% sure) amoxicillin. When I went to the pharmacy to collect the prescription they had deleted the amoxicillin and only given me the flucloxacillin. I asked why this was and they said because it does the same job so you don't need both. I asked why the doctor would have prescribed both and she said she didn't know but that she had checked with a consultant and that this was fine. They couldn't contact the doctor who had seen me. I went back to A&E to try to find her but after a lot of running around (on crutches) it turned out she was getting ready for surgery. Fair enough.
My problem is that nobody gave me a good reason as to why the doctor had prescribed both when apparantly everyone knows they do the same thing. Then it turned out that it wasn't hospital policy to prescribe both and that the doctor I had seen was a locum.
It may well be that what I have is fine and had I seen a doctor who only prescribed the one drug I'd be none the wiser. The trouble is whenever anyone was querying what I was asking they were never asking the right questions. For example a nurse phoned someone asked "Is flucloxacillin right for treating skin infections?". The answer was yes so of course in the eyes of the nurse the adjusted prescription was right. Is this the case if you've been swimming with all the stuff floating about in the Thames? Is this right if there is a broken bone nearby? I don't know because that question was never asked. Despite numerous polite and reasoned questions it got to the point after an hour where it was clear they would have said anything to get rid of me. It ended up where they said that either you can wait for the doctor I saw to finish surgery (with no estimated timeframe whatsoever, could have be 30 minutes or 10 hours) or you can take the adjusted prescription.
Now I'm sure that what I have will be fine but when the reasons for the change start with "Perhaps she meant...", "Maybe she thought..." and "What she probably meant was..." rather than "This is wrong because of x, y and z" it doesn't leave me with much confidence in the decision.
Seeing as I quite like my foot I was just after some reassurance really. Sorry for the ramble and thanks in advance!
I think the doctor gave you both flucloxacillin and amoxicillin because they cover slightly different bugs. Flucloxacillin covers staphylococci whilst Amoxicillin covers streptococci, both are common in cellulitis. More info in link below:
http://www.gpnotebook.co.uk/simplepage.cfm?ID=4833...
http://www.gpnotebook.co.uk/simplepage.cfm?ID=4833...
996c2 said:
I think the doctor gave you both flucloxacillin and amoxicillin because they cover slightly different bugs.
Ahh, that's why I was querying it. They changed the prescription and only gave me the flucloxacillin. They did this without consulting the doctor who examined me, which seems pretty unprofessional to me. Is it usual for a doctor or pharmacist to ignore a doctor's diagnosis and treatment without even discussing it with them? And not only that, it seems that I was lied to when they said that they did the same thing. Trouble is that had I waited for the doctor I had seen to get out of surgery I could still be there now and still without any antibiotics. I suppose I'll have to keep an eye on it and go back in if it gets worse.
The link's not working at the moment for me so I'll have a read tomorrow morning. Perhaps that will shead some light on it!
We would never give amoxicillin and flucloxacillin for cellulitis, we normally give flucloxacillin and penicillin. Flucloxacillin is the standard drug if choice in wound infections and open fractures. Looking at the picture above, it doesn't appear cellulitic although not clear to see.
Amoxicillin would only be given if a wound swab showed sensitivity to that antibiotic. Amoxicillin is generally used for ear/ dental/ chest infections.
http://www.cks.nhs.uk/mobiledevices/ckscontent.asp... see here for management of cellulitis (you made need to remove mobiledevices from the link.
Amoxicillin would only be given if a wound swab showed sensitivity to that antibiotic. Amoxicillin is generally used for ear/ dental/ chest infections.
http://www.cks.nhs.uk/mobiledevices/ckscontent.asp... see here for management of cellulitis (you made need to remove mobiledevices from the link.
In my experience at GP surgeries and in hospital, usually people are prescribed only fluclox. I had cellulitis on my leg earlier this year and they were about to prescribe me just fluclox, before I mentioned my allergy and was given clarithromycin instead.
Perhaps the locum was unsure of local guidelines and put them both down on the script in order for the more knowledgeable pharmacist to choose which one is more commonly used in that hospital? I've seen that done many times with other drugs.
Perhaps the locum was unsure of local guidelines and put them both down on the script in order for the more knowledgeable pharmacist to choose which one is more commonly used in that hospital? I've seen that done many times with other drugs.
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