Just a simply thing really.
I consulted a pharmacist today because a blister on my foot had become very sore and inflamed and I wondered if it was infected.
Pharmacist told me that indeed it was and should not leave it until after the weekend, as it didn’t look very good at all - I am on holiday - she said I needed antibiotic and what a shame that she could not prescribe it yet - but the government is planning to allow pharmacist to prescribe antibiotics soon.
I then had to go to the local hospital with a drop in minor injury centre. The triage nurse said immediately - no not infected, but leave off the dressing and let it dry - she asked another clinician who said the same. It is already beginning to look better.
So - if said pharmacist had the ability to prescribe antibiotics, I would have taken them needlessly and it would not have done the trick anyway.
Makes you think.
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Health
Are pharmacists sufficiently trained?
(136 Posts)Erm an infection probably would need pathology for specific confirmation.
I would certainly trust a pharmacist and indeed consult when unsure.
I would imagine he was covering himself. We live in a litigious society.
I would trust a pharmacist.
Yes I did trust the pharmacist, and still would if I thought (now )that they had sufficient training.
The point being that she immediately said after looking at it that it was infected, that I needed an oral antibiotic - she named the medicine- that she would prescribe it if she could - not to leave it as it looked nasty- in fact she mailed my surgery at home recommending the antibiotic and said if I phoned my surgery the doctor would probably E-mail the prescription to the pharmacy.
My doctor refused without seeing my foot, and recommended the minor injuries clinic.
Actually, pharmacists train for 6 years, so I’m pretty certain that they are sufficiently trained. However, like GP’s, they are not specialists in a particular area in the way that a Consultant will be (though I imagine they will specialise in a particular area during their training, but as I’m not medically trained at all, I don’t know). However, they will have to keep up to date with new developments, just as any medical practitioner will have to.
It isn’t a question of not trusting the pharmacist - you are reading something that is not there.
It is a question of whether the pharmacist has had sufficient training. I would say no by my experience. And no one should prescribe antibiotics to cover themselves! That is plain ridiculous.
I wouldn’t worry too much. Pharmacists will have to be trained and certified as independent prescribers to be able prescribe antibiotics, and will only be able to prescribe within the remit of a patient group directive. It’s very tightly managed, we’ve been doing it in Wales since April 2022.
i wouldn't take a chance with soft tissue infection;
having seen what can happen, in worst case scenario, NF, in someone.
no criticism for the pharmacist at all.
Just to clarify, independent prescribing is a post graduate qualification for pharmacists, not part of their initial training, so not all pharmacies can offer the service, because undertaking the qualification is a big commitment.
It depends.
Not all pharmacists are trained to Masters degree level.
Some are pharmacy assistants.
Whitewave It might very well have been infected, but your own immune system beat it.
However, I do think there's a real danger that antibiotics will be over-prescribed. GPs already overprescribe them because they don't/can't wait for the results of swabs before prescribing the appropriate antibiotic.
I give up.
None of you have got the point. If she now had the ability to prescribe and give me an oral antibiotic she would have done so. But it would have been the wrong diagnosis. And she would have given a patient antibiotics that were unnecessary.
Whitewavemark2
It isn’t a question of not trusting the pharmacist - you are reading something that is not there.
It is a question of whether the pharmacist has had sufficient training. I would say no by my experience. And no one should prescribe antibiotics to cover themselves! That is plain ridiculous.
We don't know if you saw a fully trained pharmacist who would be as well if not better trained than a nurse but areas of expertise and specialism are different.
Our local hospital consultants consider pharmacists sufficiently knowledgeable to be able deal with patients for routine appointments as part of their teams.
Whitewavemark2
I give up.
None of you have got the point. If she now had the ability to prescribe and give me an oral antibiotic she would have done so. But it would have been the wrong diagnosis. And she would have given a patient antibiotics that were unnecessary.
I did get the point Whitewavemerk, I can’t have explained what I meant clearly enough, sorry. If the pharmacist was an independent prescriber, which we don’t know, she would be working within a patient group directive, which has very tight criteria around when to prescribe antibiotics. She was flying a kite by telling you she would prescribe antibiotics, because there isn’t yet a patient group directive in England for her to follow.
Whitewavemark2
I give up.
None of you have got the point. If she now had the ability to prescribe and give me an oral antibiotic she would have done so. But it would have been the wrong diagnosis. And she would have given a patient antibiotics that were unnecessary.
I think I have got the point! I wrote that I think that when pharmacists can prescribe antibiotics, there's a danger they will be over-prescribed. I don't think that's to do with lack of training. Your foot might have been infected for all I know, so it might have been the correct diagnosis, but the human body is very good at fighting minor infections and antibiotics aren't always necessary. Unless the doctors did a swab and waited for the results they didn't know either. That doesn't mean that they wouldn't have killed the infection more quickly.
Well, I am an ordinary woman off the street. Clueless about anything medical and followed government guidelines by initially consulting a pharmacist. All I can say is that she seemed confident that she will eventually prescribe antibiotics. I found the consultant pharmacy by looking at the NHS site.
I suppose it is possible that she was right and the clinicians wrong. Time will tell I suppose when my toe drops off - it is still red, swollen and sore.
Not sure what else I could have done.
Whitewavemark2
I give up.
None of you have got the point. If she now had the ability to prescribe and give me an oral antibiotic she would have done so. But it would have been the wrong diagnosis. And she would have given a patient antibiotics that were unnecessary.
In fairness to the pharmacist, infection cannot be definitively proven or excluded without a swab being taken. There may be strong indicators for infection such as green pus or offensive smell but in the absence of such factors, the clinician has to go on basis of probability. How often will a GP prescribe antibiotics for a suspected urinary infection without waiting for culture results from a urine sample?
Wish I hadn’t started the thread now. 😄
please keep a close eye on that toe, OP.
and don't delay to seek antbx if there is any spread.
welbeck
please keep a close eye on that toe, OP.
and don't delay to seek antbx if there is any spread.
What is NF? Or is it better I didn’t know😧😧😮😮
Totally agree Calypso I have happily sort advice from a pharmacist and only yesterday advised a friend who had a nasty wound from an over exuberant new puppy to do so
The pharmacist advised Aand E and my friend was a bit miffed as she thought it would all heal itself however she went and ended up having a tetanus jab and antibiotics
Pharmacists are sufficiently trained for their current role and would be capable of correctly prescribing ABX for say chest infections or UTIs - but most high street pharmacists would not have seen many infected foot blisters, whereas a nurse in Minor Injuries would.
I assume in their forthcoming role they won't be expected to prescribe for all illnesses, that's what we have doctors for.
Calipso
Whitewavemark2
I give up.
None of you have got the point. If she now had the ability to prescribe and give me an oral antibiotic she would have done so. But it would have been the wrong diagnosis. And she would have given a patient antibiotics that were unnecessary.In fairness to the pharmacist, infection cannot be definitively proven or excluded without a swab being taken. There may be strong indicators for infection such as green pus or offensive smell but in the absence of such factors, the clinician has to go on basis of probability. How often will a GP prescribe antibiotics for a suspected urinary infection without waiting for culture results from a urine sample?
Over-prescribing of antibiotics is a potential hazard.
However, with a UTI, speed of treatment is often essential as it could turn to sepsis.
A soft tissue infection be cellulitis which needs prompt treatment.
I hope it gets better soon without the need for antibiotics, Whitewave and you can enjoy your holiday.
could be
Callistemon21
Calipso
Whitewavemark2
I give up.
None of you have got the point. If she now had the ability to prescribe and give me an oral antibiotic she would have done so. But it would have been the wrong diagnosis. And she would have given a patient antibiotics that were unnecessary.In fairness to the pharmacist, infection cannot be definitively proven or excluded without a swab being taken. There may be strong indicators for infection such as green pus or offensive smell but in the absence of such factors, the clinician has to go on basis of probability. How often will a GP prescribe antibiotics for a suspected urinary infection without waiting for culture results from a urine sample?
Over-prescribing of antibiotics is a potential hazard.
However, with a UTI, speed of treatment is often essential as it could turn to sepsis.
A soft tissue infection be cellulitis which needs prompt treatment.
I hope it gets better soon without the need for antibiotics, Whitewave and you can enjoy your holiday.
You have said exactly what I was trying to say.
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