Medical

Time to drop 'complete the course' antibiotic message

Time to drop 'complete the course' antibiotic message

"'Complete the course' is taught very widely, but it's been known to be wrong for quite a while", said Dr. Martin Llewelyn, a professor of infectious diseases at Brighton and Sussex Medical School in the United Kingdom and the lead author on the opinion piece.

"Historically, antibiotic courses were driven by fear of under treatment, with less concern about overuse", said lead author Martin Llewelyn professor of infectious diseases at Brighton and Sussex Medical School.

Most bacteria which make people ill are found widely in the community - and bacteria such as Staphylococcus aureus only make people ill when they get into the bloodstream or the gut.

Antibiotic resistance has become a growing problem in recent years, now serving as a threat to human health, Newsweek reports.

'Completing the course goes against one of the most fundamental and widespread medication beliefs people have, which is that we should take as little medication as necessary'. But she cautions that patients should not stop taking their prescribed antibiotics on their own.

"As researchers have pointed out, further research is needed before the "Finish the course" mantra for antibiotics is changed and any alternative message, such as, 'Stop when you feel better, ' can be confidently advocated".

"In many previously healthy patients with acute infections, letting them stop the antibiotics once they feel better has considerable appeal".

On the other hand, there are cases where nuking an infection is important. Instead, they say there is evidence that stopping antibiotics sooner is a safe and effective way to reduce overuse of the drugs.

"This brief but authoritative review supports the idea that antibiotics may be used more sparingly, pointing out that the evidence for a long duration of therapy is, at best, tenuous". "It is always possible that shortening the duration of treatment can allow the infection to recur", he said in an email, but "the evidence that does exist-although not very extensive-suggests it is safe to do this, and that any relapses that do occur are a nuisance rather than being risky".




Jodi Lindsay, a professor of microbial pathogenesis at St George's, University of London, said it was sensible advice.

They say in The BMJ that it's time for policy makers and doctors to drop the message and state that it wasn't evidence-based and is incorrect. When it comes to treatment for our bacterial infections, it has always been thought that cutting a course short eradicates most but not all of the bacteria behind the illness, thus leaving the door open for the pathogens to develop the ability to evade attack by the drugs.

But the Royal College of Global Positioning System expressed concerns.

Existing recommendations are largely based on clinical trials, says Helen Boucher, a professor of medicine and infectious diseases at Tufts Medical Center and a spokesperson for the IDSA.

"In many cases courses are quite short, for example for urinary tract infections, three days is often enough to cure the infection", she said.

"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". "Changing this will simply confuse people".

Public Health England said patients should continue to follow their doctor's advice.

Alison Holmes, director of Infection Prevention and Control at Imperial College Healthcare NHS Trust, said the "dogma" of telling patients to complete the course of antibiotics "has been pervasive and persistent". Alexander Fleming's early work showed that sensitive bacteria could be "acclimatized" to penicillin, and in 1945, he spoke about a man who didn't take enough of the drug and passed strep throat-now in a drug-resistant form-onto his wife, who died from the infection.


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