Sunday 23 March 2014

Is the benefit of antibiotics for children due to excipients?

I recently had the opportunity to witness first hand the effects of amoxicillin syrup (sugar-free) on a child, who would perk up dramatically (almost bouncing off the walls) within minutes of each dose. It seems highly unlikely to me that this is due to amoxicillin itself. Could it be due to the other ingredients in the medicine (excipients)? Could this be why some parents are so keen for doctors to prescribe antibiotics?

The brand of this preparation was Bristol Laboratories and contained the following excipients, beside which I have inserted the comments of pharmacist +Cathy Cooke):

  • Sodium benzoate (E211)
    • Not recommended for consumption by children as food additive
  • Disodium edetate
  • Sodium citrate
  • Citric acid anhydrous
  • Sorbitol (E420)
    • Not recommended for kids < 1yrs
  • Saccharin sodium
  • Gum Arabic
  • Amyl acetate
  • Amyl valerianate
  • Orange oil
  • Quinolone yellow (E104)
    • Banned in most countries. Not recommended in children!
  • Xanthan gum

If only parents could buy this stuff without the antibiotic itself!

Elect John Cosgrove to RCGP Council

How can we free up time for ourselves and our patients?

GPs as a profession must define for ourselves what is and what should not be our responsibility. For too long, society and politicians have directed to us whatever issues they cannot solve and then blamed us for outcomes beyond our control, whether it be A&E attendances, failing hospitals, "benefits cheats", infant mortality or "missed diagnoses". The result is widespread overmedicalisation, which we must reverse.

GPs should be the last resort for self-limiting illnesses, employment, relationship and emotional difficulties or primary prevention, not the first. We must restore this balance to survive in the face of an ageing population desperately in need of our medical skills. Screening and case-finding are no substitute for caring medical generalists.

RCGP should define appropriate practice, not lawyers, to allow GPs to continue to absorb risk and spare patients and the NHS from the harms of over-investigation and over-treatment.

Council must be transparent. New policies should be published for appraisal by all members before approval. This is essential if College is to engage with members and capitalise on their expertise to develop optimal policies, responsive to the needs of hardworking GPs. This will also strengthen Faculties, the life-blood of College, by enabling them to facilitate debate at the local level.

These are the principles which will guide how I will represent you at Council.