Advising a mother not to give her child an antibiotic. Thoughts?

[kl06229]

One saturday afternoon, I was approached by a parent concerned the GP had given wrong dosing instructions for amoxicillin 125mg/5ml for her 5 month old child.

The dosing was 5ml tds. Normally for a child of this age it'd be 2.5ml, and only higher in severe infection.

Apparently the pharmacist who dispensed this (different pharmacy) had not given much advice or enquired about this with the prescriber.

Through questioning, my impression from the parent was her child was not seriously ill and I advised to stop the antibiotic until the weekday and treat any symptoms with calpol and tixylix for the moment.

My belief is that giving the medicine would possibly do more harm than not giving it. What are everybody's thoughts?

[crit care]

brave of you to suggest to the parent to stop the antibiotic. You've established its not an overdose as can go higher in severe infection..even if not a severe infection, still not an overdose.

i would of thought you would be overtreating the infection..surely better than undertreating it?? and then still better than stopping the antibiotic mid course...surely when handing out antibiotics, the piece of advice i give is to make sure you complete the course, even if you do fell better after day 3.....

i guess worst case scenario would be an increase in side effects of the amoxicillin, but its still quite a broad spectrum antibiotic

[hibernia]

Through questioning, my impression from the parent was her child was not seriously ill and I advised to stop the antibiotic until the weekday and treat any symptoms with calpol and tixylix for the moment.

The thing about 5 month old babies, and children in general, is that it can be very difficult to judge if they are seriously ill. Their condition can change very quckly, especially if the baby had got several doses of 125mg amoxycillin.

Most doctors are fairly cautious about prescribing antibiotics and in the absence of proof to the contrary I would assume the doctor examined the baby and had a good clinical reason to prescribe. What about the weight of the baby? Some are bigger than average and may need a higher dose.
Previous history could also be important, e.g. if the baby was prone to ear or chest infections the doctor may have been trying to prevent a simple infection getting worse.

[SolomonQ]

shoudn't have advised to stop the antibiotic, as in the sitcom "what a plonker". bad practice. first of all, do no harm. i've seen many such prescriptions. Professional duties should be kept under consideration in all decisions.