Antibiotics for viral URTI - Communication

Question 1

General approach - introduction

Answer 1

WIPE

Hello, my name is An, I’m a 3rd year medical student.
Can I confirm your name and DOB?
I understand you’ve come to the GP today because you’ve had a cough.
Would you be happy to tell me more about your cough?

Question 2

Brief history

-key questions

Answer 2

Characteristics of URTI

• fever
• cough
• sore throat
• runny nose
• sneezes

Duration

What have they done to manage symptoms
What have they not been able to do as a result of their URTI?

Question 3

How to differentiate between a viral and bacterial infection

Answer 3

Could use CENTOR criteria here

Viral - around a week

• cough
• no exudates on throat
• no neck LN
• no/low fever
• more common in adults
• watery secretions and mucus

Bacterial

• no cough
• exudates on throat
• neck LN swelling
• high fever
• more common in children
• high fever
• purulent secretions and mucus

Question 4

Reasons why you would not want to give ABx for viral infections

Answer 4

It won’t be effective - you will get better on your own accord
-the symptoms that you have sound like they are viral

We don’t want to prescribe our patients medications if we don’t think they will be effective

In the short term, they may do more harm than good from the SEs

• N+V, C+D
• abdominal pain

In the long term, there is a risk of increasing bacterial resistance to antibiotics

• over the past few years, we’ve found that some bacterial infections are getting harder to treat with antibiotics as they have developed resistance
• this is a serious problem because these bacteria often cause very serious, sometimes lifethreatening infections.

We don’t want to put patients at an increased risk of harm in both the short and long term
But there are other ways that you could manage your cough

Question 5

Assessing the patient’s understanding

Answer 5

Why do you think antibiotics would be helpful?

What is your understanding of what antibiotics are and what they do?

Question 6

Ways to support the patient

• resources
• safety netting

Answer 6

SUMMARISE AT 2MIN MARK

Resources
-leaflets, NHS website

Conservative management
-fluids, paracetamol for fever, throat lozenges, rest

I appreciate that I’ve given you a lot of information. What I’ll do is pass you some leaflets on antibiotic resistance which outlines the key points that we’ve discussed today. If you want any further information, a good place to go is the NHS website

It sounds like you have a viral infection.
However, if you find that you’re not getting better in around 3wks, getting worse, please don’t hesitate to contact the GP or go to A&E