Prescription - to fill or not to fill?

[justjulie]

My son asked me to take him to the clinic yesterday so I know he was really not feeling well. After a couple of hours at the clinic the doctor took one look at his throat and said "yep, swollen tonsils and enflamed lymph nodes". He swabbed him for strep but that test won't be back until Tuesday likely. He said the infection looks viral but gave me a prescription for Zithromax "in case it turns bacterial". If he's no better by Tuesday, bring him back.

My question is this - he is still in AGONY this morning - do I go ahead and fill the prescription and give it to him or make him wait until Tuesday and go back to the clinic?

 

[Tigger&Belle]

Why didn't he do a 5 minute quick test, with the other test as a back up in case the quick test came back negative?

 

[Disney Doll]

Infections often harbor both a viral and bacterial component to them. Or they start out viral, the genral immunity decreases due to the viral illness and then an opportunistic bacterial infection swoops in.

I'd fill the Rx and start it.

 

[bananiem]

Around here the doctors tell you to take the med's until you get the call that the 24 hour culture is negative. That way if it is positive you've caught it one day earlier and then they can be on the med for 24 hours and then they're considered not contagious and can return to activities if they feel like it.
I'm curious why they won't have the results until Tuesday if they took a culture yesterday.

 

[minniecarousel]

No question in my mind - I'd fill it ASAP!

 

[luvmydogs]

When my ds was three he had glumerulonephritis, which is a strep infection that has also infected the kidneys. He woke up in the middle of the night with a high fever and sore throat--took him to the Dr. the next morning, dx'd with strep and had antibiotics in him by 11am, and it still traveled to his kidneys. He was sick for a while, and required many follow-ups to the Dr., but was eventually fine. Glumerulonephritis doesn't happen often, but it can be serious.

I'd start the Rx.

 

[justjulie]

Thanks everyone.

Quick test - never heard of such a thing. He said because it was viral Tylenol and chicken soup would be the way to go ...

I would have thought that since it was obviously some type of infection, why not start the script to be on the safe side. I agree that while it starts viral, it usually turns bacterial because he's so run down and his body simply can't fight it anymore and in swoops the bacteria.

It takes ALOT to stop a teenage boy from eating so I KNOW he's not well.

Thanks everyone, I think I'm going to fill the script tonight and get him started - then he'll be better by the weekend.

I knew I could rely on the trusted advice of parents on the DIS ...

 

[Tigger&Belle]

Actually, I've never had a viral sore throat turn bacterial in me or my kids. Not saying that it can't happen, of course, but it's not how it always happens. Maybe the quick tests are not what's normally done in Canada, but they are always done here (at least that's my experience).

 

[justjulie]

I've had my son in for strep testing on more than one occasion and they've never done a "quick" test - we've always had to wait. I don't know why it takes until Tuesday to get the results back - maybe they don't have lab pickup on Sundays.

I know it's very infected because my son has a very high pain tolerance and the doctor barely looked at this throat before declaring an infection.

 

[Tigger&Belle]

One other thing--what are his other symptoms? I was just reading about strep this weekend since my 12yo is sick. In reading the symptoms I was reminded that besides a sore throat, high fever, etc and all the things that go along with strep, one thing that does NOT go along with it is a runny/congested nose, which my son did have.

The dr tested him for strep just in case, which came back negative. He did test positive for the flu.

 

[bananiem]

My sister is a lab supervisor. She says not to trust a negative on a "quickie" strep test. They yield MANY false negatives. It's great if it turns positive right away, but the negative ones often turn up positive after the culture.

 

[justjulie]

No runny nose - just really sore throat and trouble swallowing - I guess so if your tonsils are swollen! Poor kid, I really feel for him - he's just miserable and I hate to see my boy like that.

 

[Tigger&Belle]

I would have thought that since it was obviously some type of infection, why not start the script to be on the safe side.

The reason is because you do not want his body to end up resistent (sp?) to antibiotics, a BIG problem with the overuse of antibiotics. Only use them when it's a bacterial infection, never for a viral infection--they won't do any good.

 

[golfgal]

Maybe the Rapid Strep test is only in the states? They have been using it here for years. It takes about 5 minutes and if you get a positive on that they will give you an antibiotic. If you get a negative, they will grow the culture for 24-48 hours and if that comes back positive will call in a med for you.

Strep is all over in our town, I would fill the script and give it too him. Since zithromax is only a 5 day med, I would just go a head and give him the full course.

 

[Tigger&Belle]

My sister is a lab supervisor. She says not to trust a negative on a "quickie" strep test. They yield MANY false negatives. It's great if it turns positive right away, but the negative ones often turn up positive after the culture.

I've heard the same thing. Trust the positive and culture if the quick test is a negative.

Darn, I didn't insist on that with my son on Saturday. I was assuming that his sore throat was only from the flu, which it probably was. Guess if it doesn't go away we'll be back at the dr.

 

[justjulie]

Apparently Zithromax is often prescribed for tonsilitis too - I know his tonsils are swollen because the doctor told me so - at least I know he's being prescribed the right antibiotic.

Just when I though we might actually get through the winter without a mishap ...

 

[Tigger&Belle]

Just when I though we might actually get through the winter without a mishap ...

That's the problem! You never should have thought that!

 

[justjulie]

I know - I probably cursed myself! Looks likes he's made it through the school day - tough guy. I'll see how he does tonight - no strep result yet - I just checked for messages ...

 

[Tigger&Belle]

I think that my son will be able to go to school tomorrow. He somehow made it through on Friday, the first day of the flu (I didn't know he was sick), but he stayed home today. Can't wait for this illness to be over. Keep us posted about your son's results.