I agree, I don't think this is a rural vs urban problem. One of the reasons I like Rynatan-S is that it is thick and milky and looks like an antibiotic- comes in handy sometimes. Regards- Kim Burlingham, MD who had an easy Saturday clinic and is too lazy to go out and weed. -----Original Message----- From: <> To: <>; <> Date: Saturday, October 09, 1999 1:58 AM Subject: Re: Rural Peds (kind of long) >Before I settled here in Las Vegas, my wife and I did a year of locums >accross the country in various settings from rural Georgia, Kentucky, and >North Dakota, to New Orleans, Atlanta and Los Angeles. I can assure you the >problem of folks treating viral illness with antibiotics occurs everywhere. >When I arrived, I saw many "overflow" patients from my busiest partner who >treated every uri with antibiotics. I had to experiment with what words to >use to convince them that this time we would withhold antibiotics. I explain >the difference between virus and bacteria and give examples of the type of >infections that need antibiotics. I say something like : " if he had an ear >infection, strep throat or bronchitis, then he certainly would be helped with >antibiotcs, but unfortunately, with viruses it will only potentially hurt by >causeing possible side effects like diarrhea or upset tummy; and unnecessary >antibiotics will only make future infections more difficult to treat by >helping bacteria become more resistant to the simple antibiotics. You call me >Thursday if the fever isn't gone or the symptoms are not starting to improve. >Then we will talk about the possible need for antibiotics or getting more >information by, for example, getting an X Ray of his sinuses." (of coarse I >rarely do sinus films). If they are really freaked out, I have a nurse do a >progress call the next day. I have to admit, I also will give an Rx for a >decongestant/cougn med for those who I sense need an Rx in hand. It takes >more time, but it works. My partner now prescribes fewer antibiotics, I >think because the patients now have different expectations. I wonder how >others out there deal with the child whose parents both got antibiotics and >expect them for their child with the same symptoms? I usually say something >like "in adult medicine, they give a lot more antibiotics" > Blair Duddy, gen peds > > >