Researchers and doctors all over the globe still argue about the point when they should recommend patients to cease taking antibiotics. The new review of randomized clinical trials has suggested that while patients have fears of under-treatment (taking antibiotics for a shorter period than necessary), they’d better concern about the opposite thing: a risk of overuse of these medications. This review was published by a group of scientists from several UK universities, including Brighton and Sussex Medical School, the University of Oxford and the University of Southampton.
Doctors have always insisted on patients finishing a full course of antibiotics even if they start feeling better. It is believed that this approach will protect from the relapse with the same strain and decrease the risk of antibiotic resistance.
However, the authors of the review have suggested that taking antibiotics for fewer days may be as effective as a «finishing the course» approach. Moreover, they are convinced that finishing the full course of antibiotics might lead to making the problem of antibiotic resistance even worse.
Briefly, here are the bullet points of the review:
- Only few trials have investigated the minimum number of days needed for antibiotics to be effective. That is why there is very poor evidence to support the opinion that shorter courses of antibiotics would result in treatment failure or an increased risk of bacteria becoming resistant to antimicrobial therapy. However, authors acknowledge the fact that there are some medical conditions when taking antibiotics for a shorter period may compromise recovery.
- When doctors on a regular basis prescribe a fixed number of days for a course of antibiotics they do not consider individual patient characteristics which might affect the way or an extent to which patients will respond to the treatment.
- It is hard to test the hypothesis whether taking antibiotics for a shorter period may be as effective as «finishing the course» approach or not, because the importance of finishing a full course of antibiotic treatment is “deeply embedded in both doctors and patients”.
- It is necessary to provide public health education around antibiotics needs and tell people that antibiotic resistance we are facing now is the result of the overuse of antibiotics by patients. We can’t prevent it by completing a full course. Authors are positive that it is beneficial to use simpler messages for public such as, “stop when you feel better.”
Professor Peter Openshaw, President of the British Society for Immunology and Professor of Experimental Medicine at Imperial College London has commented this review: “It could be that antibiotics should be used only to reduce the bacterial burden to a level that can be coped with by the person’s own immune system. In many previously healthy patients with acute infections, letting them stop the antibiotics once they feel better has considerable appeal. However, there are clearly circumstances where antibiotics should be given for extended periods”.