diarrhoea+or+rash+from+antibiotic+treatment

=Diarrhoea/Rash from Antibiotic Treatment=

//A young woman walks into your pharmacy,// //requesting some anti-diarrhoeal medication.// //You find out it was caused by some antibiotics that she was taking to treat a UTI//.

Problem
Balancing treatment of the UTI with treatment of the diarrhoea

Questions to Ask
How long have you had symptoms of diarrhoea for? //a few days// How often do you need to go to the toilet (and how often do you go normally)? (determine severity of diarrhoea) Do you know what may have caused your diarrhoea? //I'm not sure// What medications are you on? //just started amoxycillin// What are you using the antibiotic for? //a urinary tract infection//

What to do
You have determined that the antibiotic could be the cause of the patient's diarrhoea. They cause diarrhoea due to an imbalance of intestinal flora, which may take a few days to regenerate after the antibiotic is withdrawn (diarrhoea may not stop straight away). Anti-diarrhoeals are only recommended if the person has an important event (business meeting, travelling etc.) and wants to temporarily withhold the symptoms.

If they developed a rash, then offer an anti-histamine cream. (?)

You should refer them to the doctor to switch to an alternative medication (trimethoprim). However, if they are unable to for a few days, then you should ask to them to see a doctor who is currently available (although some believe that using a previous supply of UTI medication would be sufficient until they can see the doctor).

The patient had contracted a UTI a while ago and was prescribed trimethoprim. However, she did not complete the course and suffered a relapse. She then went to the doctor and was prescribed amoxycillin (although cephalexin is 2nd line, and clavulanic acid should be added) to control her infection. However, she developed diarrhoea and has come into the pharmacy to request anti-diarrhoeals.
 * Full Scenario**

Resources
[|Self-Care Card - UTI] [|NPS - Antibiotic use in UTI]: an indepth view into types of antibiotics used in UTI [|NPS - "I'm allergic to penicillin"]: explains penicillin allergy and what to do (in terms of prescribing) [|ASCIA - Allergic reactions to antibiotics]: contains risk factors and practice points