Completing course of antibiotics may 'do more harm than good'

30 July 2017

"There is evidence that stopping antibiotics sooner is safe and effective."

It's a rule repeated time and time again - always complete the full course of antibiotics when ill.

However, researchers are now arguing that this mantra is not backed up by evidence, and should be dropped.

Professor Martin Llewelyn of Brighton and Sussex Medical School and his colleagues have published a document in The BMJ (British Medical Journal) urging policy makers, educators and doctors to reconsider antibiotic use, as they believe that taking the drugs for longer than necessary increases the risk of resistance.

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"There is evidence that, in many situations, stopping antibiotics sooner is a safe and effective way to reduce antibiotic overuse," the academics said in a statement, adding, "There are notable exceptions for some types of antibiotic, such as those used to treat tuberculosis."

The researchers went on to note that the concept of completing the course also goes against one of the most fundamental and widespread medication beliefs people have, which is that we should take as little medication as necessary.

Accordingly, they are calling for more research to determine the most appropriate simple alternative messages, such as "stop when you feel better".

"The public should also be encouraged to recognise that antibiotics are a precious and finite natural resource that should be conserved by tailoring treatment duration for individual patients," the researchers added.

Going forward, Professor Llewelyn hopes to hold clinical trials to determine the most effective strategies for optimising duration of antibiotic treatment.

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Professor Helen Stokes-Lampard, chair of the Royal College of General Practitioners, has responded to the claims and stated that while it is important to take new evidence into account, she "cannot advocate widespread behaviour change" on the results of just one study.

"We are concerned about the concept of patients stopping taking their medication mid-way through a course once they 'feel better' because an improvement in symptoms does not necessarily mean the infection has been completely eradicated," she explained. "It's important that patients have clear messages and the mantra to always take the full course of antibiotics is well known - changing this will simply confuse people."

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