Should we really complete course of antibiotics?

Should Fighting Antibiotic Resistance Always Include Finishing A Prescribed Medication?

Sussex experts make bold new claim over antibiotics

Hicks said there is also evidence that if you don't complete a course of antibiotics, that makes it more likely that bacteria on your body may develop antibiotic resistance and cause a more serious infection down the road. "However, there are clearly circumstances where antibiotics should be given for extended periods".

It's time to drop this message because it is incorrect and not evidence-based, say Professor Martin Llewelyn, from the Brighton and Sussex Medical School, and colleagues.

The origins of the complete-the-course message regarding antibiotics "can be traced back to the dawn of the antibiotic era", when the first patient was treated with penicillin, write the authors of the new commentary.

Over time, excessive use of antibiotics could lead to minor infections causing serious health complications, making surgery and treatment for diseases such as cancer much riskier.

Other experts in infectious diseases backed the group.

"What it is is that you should take the course of antibiotics as prescribed and that doctors need to be careful that they only prescribe the necessary course of antibiotics for a particular patient for a particular condition".

Policy makers, educators and doctors need to stop advocating "complete the course" when it comes to antibiotics, United Kingdom experts have urged, saying that the "deeply embedded" link between stopping antibiotic treatment early and antibiotic resistance is not supported by hard evidence.

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Instead, each course should be tailored to the individual patient and alternative messages should be considered, such as stop when you feel better.

His team said clinical trials are required to determine the most effective strategies for optimising duration of antibiotic treatment.

"There are situations where finishing a full course is important".

When he accepted the Nobel Prize for his work in 1945, Fleming, who had noted that bacteria could mutate when exposed to the new drugs, delivered a vivid speech describing an imaginary patient with a throat infection who had failed to complete his course of antibiotics.

"The longer the antibiotic exposure these opportunist bacteria are subjected to, the greater the pressure to select for antibiotic resistance", they add. The Infectious Diseases Society of America (IDSA) has changed some of its guidelines for certain medications, based on recent studies that show shorter courses suffice.

The advice is said to be based on comments made by Alexander Fleming, who discovered penicillin more than 80 years ago.

Dr. Sharon Meropol, a pediatrician and epidemiologist at Case Western Reserve University School of Medicine, says she's "glad someone finally wrote this paper", and that she "mostly agrees" with the authors' recommendations.

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The question of how people use antibiotics is one of the most critical issues facing modern medicine.

How did the idea of "completing the course" come about?

"One of the lovely aspects of science is the self-correcting theory of knowledge", said Osterholm.

No current guidelines suggest stopping drug treatment partway through a recommended treatment course. The majority of reporting referred to the review as an "opinion piece" and highlighted the importance of people continuing to follow doctors' advice to complete a prescribed antibiotic course. Do not skip doses.

Patients have always been advised to finish their course of antibiotics even if they're feeling better.

"The article underlines that educating not only patients but also doctors is essential to changing current prescribing practices". Even designing experiments to test reducing antibiotic courses remains hard, they added, because participants are often invited to consent to receive shortened antibiotic treatment on the basis that this could reduce the risk of antibiotic resistance-yet they are "taught from school that it increases this risk".

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