Rapid responses are electronic comments to the editor. They enable our users
to debate issues raised in articles published on bmj.com. A rapid response
is first posted online. If you need the URL (web address) of an individual
response, simply click on the response headline and copy the URL from the
browser window. A proportion of responses will, after editing, be published
online and in the print journal as letters, which are indexed in PubMed.
Rapid responses are not indexed in PubMed and they are not journal articles.
The BMJ reserves the right to remove responses which are being
wilfully misrepresented as published articles or when it is brought to our
attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not
including references and author details. We will no longer post responses
that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
While I understand the need to cut down the use of antibiotics,I feel caution is needed.
I'd had few chest infections in the past and rarely needed to use antibiotics, but went to my GP feeling as if I was breathing through straw and with 'flu symptoms. I would have stayed home, rather than bother a doctor, but the main reason for my visit was because I also had acute pain on one side of my chest when taking more than the shallowest breath. In the past I had been diagnosed with pleuradynia and the symptoms (sudden onset pain, feeling as if my lungs were ripping) were identical. The GP said she could not hear any crackles, though she only listened perfunctorily and I could not take deep breaths. She gave me anti-inflammatory drugs for pulled muscles, though I knew I had not pulled any muscles. It was difficult to talk and I had little energy, so I just went home.
I was very ill for a week, unable to eat or do anything and the pain spread to both sides, back and front. When I was able to get back to to the surgery I saw another GP who prescribed strong antibiotics, but these did not clear the infection and a month later I started another course.
I had a persistent cough through that spring and throughout the summer. Asthma inhalers were tried but had little effect. When I sat down I would cough for approximately 2 hours. I found I was unable to walk up the slightest incline without becoming breathless and needing help.
In late autumn I mentioned the cough during a routine oncology check up and was sent for a scan. The diagnosis was bronchiectasis. The consultant told me I had 3 small areas of lung damage, one from infancy, a second from radiotherapy for breast cancer, and a third from this latest infection. He said it would have helped if I had received timely antibiotic drugs.
When I asked one of the GPs if my diagnosis had been discussed as a learning point at surgery meetings I was told, 'You've had this from infancy'. I repeated what the consultant had told me. He did not reply.
Before this diagnosis I rarely had colds, coughs or 'flu. Now, I get them often and the slightest cold causes a bad chest infection which means I have to use antibiotics. I have to carry standby antibiotics when I travel and invariably have to use them when I visit my grandchildren, who often have colds, so my relationship with them is affected - also my visit.
Now I not only suffer from chest infections, the antibiotics I have to use have a dire effect on my stomach and intestines, the latter having been irradiated for anal cancer: I feel sick, cannot eat normally and diarrhoea causes the irradiated skin of my buttocks to become raw.
I have had two different cancers and have a great deal of pain from side effects of treatment and also from osteoarthritis of the spine. Bronchiectasis on its own would be a burden but as an extra health condition has a huge impact on my quality of life. I can't help feeling this was a preventable condition; that I am just collateral damage from a policy that is too general and sweeping. And apparently no-one will even have learned from this, so other people will be at risk.
Re: Antimicrobial resistance presents an “apocalyptic” threat similar to that of climate change, CMO warns
While I understand the need to cut down the use of antibiotics,I feel caution is needed.
I'd had few chest infections in the past and rarely needed to use antibiotics, but went to my GP feeling as if I was breathing through straw and with 'flu symptoms. I would have stayed home, rather than bother a doctor, but the main reason for my visit was because I also had acute pain on one side of my chest when taking more than the shallowest breath. In the past I had been diagnosed with pleuradynia and the symptoms (sudden onset pain, feeling as if my lungs were ripping) were identical. The GP said she could not hear any crackles, though she only listened perfunctorily and I could not take deep breaths. She gave me anti-inflammatory drugs for pulled muscles, though I knew I had not pulled any muscles. It was difficult to talk and I had little energy, so I just went home.
I was very ill for a week, unable to eat or do anything and the pain spread to both sides, back and front. When I was able to get back to to the surgery I saw another GP who prescribed strong antibiotics, but these did not clear the infection and a month later I started another course.
I had a persistent cough through that spring and throughout the summer. Asthma inhalers were tried but had little effect. When I sat down I would cough for approximately 2 hours. I found I was unable to walk up the slightest incline without becoming breathless and needing help.
In late autumn I mentioned the cough during a routine oncology check up and was sent for a scan. The diagnosis was bronchiectasis. The consultant told me I had 3 small areas of lung damage, one from infancy, a second from radiotherapy for breast cancer, and a third from this latest infection. He said it would have helped if I had received timely antibiotic drugs.
When I asked one of the GPs if my diagnosis had been discussed as a learning point at surgery meetings I was told, 'You've had this from infancy'. I repeated what the consultant had told me. He did not reply.
Before this diagnosis I rarely had colds, coughs or 'flu. Now, I get them often and the slightest cold causes a bad chest infection which means I have to use antibiotics. I have to carry standby antibiotics when I travel and invariably have to use them when I visit my grandchildren, who often have colds, so my relationship with them is affected - also my visit.
Now I not only suffer from chest infections, the antibiotics I have to use have a dire effect on my stomach and intestines, the latter having been irradiated for anal cancer: I feel sick, cannot eat normally and diarrhoea causes the irradiated skin of my buttocks to become raw.
I have had two different cancers and have a great deal of pain from side effects of treatment and also from osteoarthritis of the spine. Bronchiectasis on its own would be a burden but as an extra health condition has a huge impact on my quality of life. I can't help feeling this was a preventable condition; that I am just collateral damage from a policy that is too general and sweeping. And apparently no-one will even have learned from this, so other people will be at risk.
Competing interests: No competing interests