- If a patient’s symptoms are getting worse after 5-7 days, antibiotics are appropriate.
- FSH recommends using the Centor Criteria for evaluating whether sore throat is caused by bacterial or sinus infection.
- Be sure to check the patient’s consultation history for multiple antibiotics prescriptions.
- Be sure to check medication allergies.
- Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America
- The Lancet: A controlled human infection model of Streptococcus pyogenes pharyngitis (CHIVAS-M75: an observational, dose-finding study
Medication for diabetes, hypertension, thyroid, cholesterol, behavioral health, asthma, herpes, etc.
These medications should be only refilled. You should not make a diagnosis and choose dosage during consultation.
The limit is 3 prescription refills within the calendar year. Make sure to review past consults. Only 30 days can be prescribed at a time.
For each prescription, the First Stop Health doctor must advise the patient to see PCP/original prescribing specialist.
On the 4th prescription, doctors may decline or fill one more time on a case-by-case basis.
Contraception and emergency contraception
One 90-day prescription within a calendar year
No limit for emergency contraception
Make sure to take adequate medical history
Plan B One Step can be purchased OTC by anyone of any age and does not require a prescription. Typically covered by insurance with a prescription.
Smoking cessation drugs including Zyban and Chantix
The Affordable Care Act of 2010 expanded coverage of FDA-approved smoking cessation medications. It is now considered a preventive service and covers 90 days and 2 quit attempts per year.