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Advice to complete antibiotics seen as outdated

Patients may not need to complete a course of antibiotics as previously recommended by medical advice, researchers argue, calling for clinical trials to find the optimum duration of antibiotic treatment.

Patients may not need to complete a course of antibiotics as previously recommended by medical advice, researchers argue, calling for clinical trials to find the optimum duration of antibiotic treatment

antibiotics
Advice to complete a course of antibiotics may be wrong, researchers say.
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Patients may not need to complete a course of antibiotics as previously recommended by medical advice, researchers have argued.

Researchers led by Brighton and Sussex medical school say that for common bacterial infections, the idea that stopping antibiotic treatment early encourages antibiotic resistance is not supported by the evidence.

The say patients are actually put at unnecessary risk from antibiotic resistance when treatment is given for longer than necessary.

When a patient takes antibiotics for any reason, antibiotic-sensitive species and strains present among commensal flora on their skin, gut, or in the environment, are replaced by resistant species and strains ready to cause infection in the future, according to the researchers. 

Public education

The authors of the article, published in the British Medical Journal, studied existing evidence on the use of antibiotics including randomised controlled trials.

They argue that antibiotics are a ‘precious and finite natural resource’ which should be conserved by tailoring treatment duration for individual patients.

They also call for clinical trials to determine the most effective strategies for optimising duration of antibiotic treatment.

Research is needed to determine the most appropriate simple alternative messages, such as ‘stop when you feel better’, the authors state.

They add: ‘Until then, public education about antibiotics should highlight the fact that antibiotic resistance is primarily the result of antibiotic overuse and is not prevented by completing a course.’


Llewelyn M et al (2017) The antibiotic course has had its day. British Medical Journal. doi.org/10.1136/bmj.j3418

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